• 대한핵의학회지
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• 제28권3호
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• pp.317-325
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• 1994

디피리다몰 부하/휴식 $^{99m}Tc$-MIBI 심근 SPECT에 의한 심혈관질환의 진단과 심근분절별 혈류등급의 재현성을 조사하여 판독자의 주관적인 판단이 SPECT 판독에 미치는 영향을 알아보았다. 디피리다몰 부하/휴식 $^{99m}Tc$-MIBI 심근 SPECT와 심혈관 조영술을 2개월이내에 동시에 시행한 환자 131명에서 환자의 임상정보를 모르는 두 명의 판독자가 독립적으로 스캔을 판독하였다. 1) 심혈관조영소견을 기준으로 하였을 때 전체환자 131명에 대한 두명의 판독자의 SPECT진단의 예민도와 특이도는 각각 70%, 73%와 58%, 54%였고 정확도는 67%, 70%로 판독자간에 유의한 차이가 없었다. 외래에서 SPECT 검사를 의뢰한 환자와 SPECT를 먼저 시행하고 관동맥조영술을 나중에 시행한 환자에서에서 두 판독자의 스캔진단 정확도가 입원 상태에서 SPECT를 실시한 환자와 관동맥조영술을 먼저 시행한 환자의 경우에서보다 진단정확도가 높았다. 2) 스캔판독시 두명의 판독자간의 심혈관질환의 유무에 대한 최종 스캔진단의 일치도는 93%였으며 각영역별로 구한 일치도는 89%였다. 3) 두 판독자가 29개 심근분절의 혈류에 대해서 부여한 점수는 80%에서 일치하였으며 분절점수간의 상관계수는 0.67이었다. 스캔판독이 일치하였던 경우와 일치하지 않았던 경우의 분절심근점수의 일치도에는 차이가 없어서 스캔판독의 차이가 혈류저하의 정도에 대한 평가의 차이이기보다는 영역별 혈류저하정도에 대하여 유의성여부를 판별하는 주관적 기준의 차이에 의한 것임을 시사하였다. 이상에서 심근 SPECT의 육안평가시 분절별 혈류저하 정도에 대한 평가는 판독자간에 높은 재현성을 보이며 심혈관질환의 유무에 대한 판정은 영역별로 유의한 혈류저하라고 생각하는 신뢰수준(confidence level)의 기준차이에 영향을 받는 것으로 생각되었다. 이러한 판독자별 기준의 차이가 진단에 대한 예민도 및 특이도에 영향을 주므로 분절분석평가방법을 이용하여 개인별로 적절한 평가기준을 설정하는 것이 정확한 SPECT 평가에 도움이 되리라 생각한다.

• Journal of Acupuncture Research
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• 제26권6호
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• pp.205-214
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• 2009

Objectives : This study was designed to evaluate objectively the efficacy of bee-venom acupuncture on Central post-stroke patients. Methods : After screening, 25 patients recruited with eligible criteria. Among them 1 dropped out in treatment group, 4 in control group. We applied bee-venom acupuncture 6 points of body($LI_{15}$, $GB_{21}$, $LI_{11}$, $GB_{31}$, $ST_{36}$, $GB_{39}$) 2 times a week for 3 weeks for treatment group, and normal saline for control group in the same way. After 3 weeks treatment and 2 weeks follow up we measured VAS, categorial rating scale as a pain assessment also MBI, Modified Rankin Scale as a stroke recovery. Results : 1. Treatment group showed significant difference in VAS, categorial rating scale after treatment and 2 weeks follow up, compared with baseline. The control group showed significant difference between baseline and after treatment But the 2 weeks follow up, there is no significant difference compared with baseline. Also there's no significant difference in categorial rating scale. 2. MBI showed significant difference in treatment group between baseline and after treatment, but the control group did not have any difference. There's no significant difference in Modified Rankin Scale for treatment group and control group. 3. There's no significant difference between control group and treatment group. This is because of the small sample size in the study, Thus it seems to reflect individual difference strongly. Conclusions : There are positive effect on CPSP patients in pain and stroke recovery treating with bee-venom acupuncture than control group.

• 한국재난관리표준학회지
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• 제3권2호
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• pp.41-46
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• 2010

본 연구는 최근 직물커튼의 대용으로 가장 많이 사용하고 있는 버티컬 브라인드와 롤 스크린을 대상으로 방염제품과 비 방염제품의 연소차이를 규명하여 방염의 필요성을 확인하고 방염제품의 방염성능 지속성을 실험을 통하여 규명하고자 소방대상물에 설치되어 장기간 사용한 버티컬 브라인드와 롤 스크린을 수거하여 세탁 전 후의 방염성능을 확인한다. 이 결과를 토대로 방염제품의 성능을 규명하고 외국의 방염관련 법규와 국내 방염관련 법규의 비교분석을 통하여 국내 방염법규의 확대적용 필요성과 개선점을 도출함을 목적으로 한다. 연구결과, 방염제품과 비 방염제품과의 성능과 안전성은 확연한 차이를 볼 수 있었다. 방염제품은 불꽃과 접하면 바로 연소를 하며 용융하고 단지 착화하지 않으므로 연소 확대를 막을 수 있다는 이점이 있다. 반면 비방염제품은 120 cm의 시험체가 전소하는데 불과 3분도 걸리지 않는 다는 것을 알 수 있다. 이를 실제 화재에 적용시 연소확대에 큰 차이를 보일 것이다. 내세탁성이 없는 브라인드의 경우 세탁을 하면 방염성능이 현저하게 감소할 것으로 예상을 했으나 세탁전과 비교하여 큰 차이를 보이지 않았다. 따라서 방염브라인드도 내 세탁성을 가질 수 있음을 입증하였고 엄격한 생산과정을 통한 내구성의 유지에 관심을 가져야 하겠다.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.112-117
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• 2019

Background and Objectives The purpose of this study was to develop the differential diagnosis scale containing items from adductor spasmodic dysphonia (ADSD) to muscle tension dysphonia (MTD) and the determine clinical utility of newly developed items. Materials and Method The four parts of pitch, redirected phonation, automatic speech and voiced sound were selected for analyzing the characteristics of ADSD in the literature. One part of tense voiceless sound was developed according to the Korean manner of articulation. The content validity was evaluated based on 5 scales (1-5 point) analysis from 30 experts. One hundred patients (50 ADSD and 50 MTD) were recorded in reading a sentence and sustained phonation. The two speech language pathologist evaluated recorded voices through a blind test using 4 scales (0-3 point) for newly developed items. Results As a result of verifying the content validity of items with experts, it was identified that the differentiated items were valid with 4.2 out of 5. Through the differential diagnosis between two groups according to the items, the correlation between sub-domains and total scores was shown as higher than 0.710. The result of analyzing the reliability on each diagnosis domain was 0.840-0.893, which showed the internal consistency of items was great. Newly developed five parts of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). The reliability among the evaluators was analyzed as high with 0.892. Conclusion In this study, the differential diagnosis scale of ADSD was revealed as having validity and reliability. It is considered that it will be useful for differentiating ADSD and MTD in the clinical field.

• Korean Journal of Acupuncture
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• 제34권1호
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• pp.47-55
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• 2017

Objectives : The purpose of this study is to evaluate the feasibility of further acupuncture research as an effective alternative and safe treatment for abdominal pain control in patients with pancreatitis. Methods and Results : This study is an open-label, assessment-blind, parallel designed pilot clinical trial. Thirty participants will be assigned to the acupuncture group(n=15) and usual care group(n=15). All patients will receive the conventional standard-of-care(SOC) therapy, but only the experimental group will receive acupuncture therapy six times a week, and the duration of acupuncture therapy will be held up to 12 weeks or until the pains are to be resolved. For the conventional SOC therapy, painkiller will be given. In treatment group, the subjects will receive the identical SOC therapy in combination with electroacupuncture therapy on twelve acupuncture points(LI4, PC6, SP6, GB39, ST36, ST37), and auricular acupuncture therapy on five auricular acupuncture points(Sympathetic, Shen Men, Abdomen, Pancreas gall, and Spleen). The primary outcome will be measured using the visual analogue scale(VAS), and the secondary outcome will be measured using the painkiller demand, quality of life index and severity of pancreatitis by abdominal computed tomography(CT). Assessments will be made at baseline and at week 1, 4, 8 and 12. Results of abdominal CT will be evaluated at baseline and at week 12. Conclusions : The result of this trial will provide a basis for the effectiveness and safety of acupuncture treatment for abdominal pain in patients with pancreatitis.

• 동의신경정신과학회지
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• 제19권1호
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• pp.1-18
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• 2008

The purpose of this research is to examine the effect of Simjeongkyeok Sa-am acupuncture treatment for major symptoms of Hwa-byung. Method : In this randomized, single blind, placebo-controlled study, we compared Simjeongkyeok acupuncture with Sham acupuncture in the treatment for major symptoms of Hwa-byung. Likert scale for major symptom of Hwa-byung was measured as the 1st evaluative instrument, and STAXI-K, STAI-K, BDI-K and HRV were also measured as the 2nd evaluative instrument at the before treatment and after treatment. Results : In comparison of Likert scale for major symptoms, total score of after treatment decreased significantly at each point on both groups, but there was no significant difference between both groups. In comparison of STAXI-K, STAI-K, BDI-K, there was no significant difference in variation of score between both groups. But Simjeongkyeok group showed higher ratio variation of STAXI expression than that of Sham group, Also on subjects whose main complaint symptom were burning sensation and whose pattern identification were Qizhi, Simjeongkyeok group showed higher variation of Likert scale score and BDI-K than that of Sham group. The significance was border line around. Conclusion : We considered that Shimjeongkeok treatment will he likely to he recommended for treating Hwa-byung, especially on subjects in each group whose main complaint symptom were burning sensation or whose pattern identification were Qizhi. Also it may also be effective on the management of anger expression.

• 한국재난정보학회 논문집
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• 제17권4호
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• pp.882-889
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• 2021

연구목적: 저소득계층의 주거공간인 고시원을 중심으로 화재안전성의 향상이라는 부분에 목적을 두었다. 연구방법: 화재 발생 및 피해 과정에서 나타나는 문제점을 다시 한 번 검증하는 한편, 사각지대에 대한 제도적인 논의를 통해 개선방안을 제시하고자 한다. 연구결과: 고시원화재의 위험성을 살펴본 결과, 객실 내부에서 발생하는 화재발생 원인은 다양하게 나타날 수 있으나 좁은 객실로 인한 열축적에 의한 복사열 가능성이 높고 의류 및 가재도구 등으로 인해 화재 확산 가능성도 상당하다는 것을 알 수 있었으며, 이는 내부에 가급적 많은 인원을 수용하려고 하다 보니 좁은 실내공간의 열악한 내부 구조가 화재 확산 및 피해 규모에 상당한 영향을 미치고 있다는 것이 재확인되었다. 결론: 간이스프링쿨러 미설치된 고시원에 대하여는 조속히 설치가 완료 될 수 있도록 정부 및 자치단체의 더욱 강력한 추진력이 필요한 반면, 고시원의 구조특성상 나타나는 공간적, 구조적 화재취약성에 대하여 어떻게 개선할 것인가에 대한 논의가 필요할 것이다.

• 국제지역연구
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• 제13권4호
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• pp.129-154
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• 2010

본 논문의 목적은 소련해체 이후 중앙아시아 지역안보환경의 변화 양상과 중앙아시아 지역국가들이 참여하고 있는 다자간 협력기구들의 현황 및 특성을 고찰함으로써 중앙아시아 지역안보체제의 국제정치학적 의미를 규명하고, 중앙아시아 지역안보체제의 구축 전망을 제시하는데 있다. 중앙아시아는 일찍이 '유라시아의 발칸'으로 인식되었듯이 구(舊)체제에서 축적되고 독립 후 새로운 체제로 이행하는 과정에서 발생한 각국 내부의 다양한 갈등 요소들과 상호간 분쟁 요소들, 그리고 강대국들의 전략적 이해관계가 중첩되고 있는 안보불안정 지역이다. 현실의 중앙아시아 지역안보는 미국을 위시한 서방의 이익을 대변하는 나토, OSCE 체제와 러시아를 중심으로 하는 포스트소비에트국가 간의 다자 및 양자협력 체제, 중국, 인도, 터키 등 역외 주요행위자들이 참여하는 다자협력기구들의 활동과 궤를 같이 하고 있다. 그러나 중앙아시아 다자안보협력의 움직임들은 아직까지 어느 것도 범지역적 대표성을 획득하는 단계로까지 발전하지 못하고 있다. 중앙아시아 각국 내부의 문제와 이들 국가 간의 갈등요소를 근본적으로 해결하지 않고서는 이 지역의 안보는 담보될 수 없으며, 편협하고 맹목적인 현실주의는 불안정 지역의 확산을 가져오고 유라시아대륙의 상당부분을 분쟁의 영구적인 근원으로 만들 것이다. 이러한 관점에서 중앙아시아 지역에서 미국, 러시아, 중국, EU 등 주요 행위자들의 전략적 판단과 선택은 재고되어야 할 것이다.

• 대한간호학회지
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• 제10권1호
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1992년도 춘계학술대회
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• pp.27-47
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• 1992

Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.