• 제목/요약/키워드: Park Movement

검색결과 2,791건 처리시간 0.034초

방사선수술에서 종양 움직임을 재현시킨 움직이는 팬텀을 이용하여 선량 분포의 왜곡에 대한 연구 (Distortion of the Dose Profile in a Three-dimensional Moving Phantom to Simulate Tumor Motion during Image-guided Radiosurgery)

  • 김미숙;하성환;이동한;지영훈;류성렬;조철구;양광모;유형준;서영석;박찬일;김일한;예성준;박재홍;김금배
    • Radiation Oncology Journal
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    • 제25권4호
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    • pp.268-277
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    • 2007
  • 목적: 호흡에 의한 종양의 움직임은 사이버나이프를 이용한 정위적 방사선수술과 같은 정확한 치료에 있어 고려할 만한 방해 요인이다 이 연구에서는 사이버나이프를 이용한 방사선 수술의 Interplay현상을 보고자 팬텀을 움직이게 하고 또한 움직이지 않게 하여 선량 분포의 왜곡을 조사하였다. 대상 및 방법: 팬텀은 $2.5{\times}2.5{\times}5.0$ 인치의 4개의 직육면체로 구성된 폴리에틸렌과 2장의 Gafchromic 필름으로 구성되었다. 치료 계획은 20, 30, 40, 50 mm지름을 가진 구를 가상하여 사이버나이프 치료기를 이용하여 104개의 빔 방향과 single center mode의 치료 계획 하에 총 30 Gy를 조사하였다. 특별히 제작된 로봇은 팬텀을 좌우, 전후, 두미쪽으로 각각 5, 10, 20 mm 움직이도록 고안되었다. 필름의 optical density을 이용하여 정적인 상태의 팬텀과 로봇에 의해 움직일 때의 팬텀의 선량 분포를 구하였다. 결 과: 정적인 상태에서 종양을 모두 포함할 수 있는 최소의 등선량은 20 mm 종양의 경우 80%, 30 mm에 84%, 40 mm에 83%이며 50 mm 종양에 80%였다. 정적인 상태와 움직일 때의 팬텀 사이에서 발생한 선량 분포의 차이(gap)는 20 mm 종양에서 두미방향으로 각각 3.2, 3.3 cm이며 오른쪽 3.5 mm, 왼쪽 1.1 mm였다. 30 mm 종양의 경우는 각각 3.9, 4.2, 2.8과 0 mm였고 40 mm 종양은 각각 4.0, 4.8, 1.1, 0 mm였다. 50 mm 종양의 경우 각각 3.9, 3.9, 0.0 mm였다. 결 론: 20 mm의 적은 종양을 치료할 때 80%의 등선량이 계획되더라도 움직이는 실제 치료에 있어 종양 움직임을 보완하기 위하여 60% 등선량으로 처방할 필요가 있다. 이때 두 등선량 곡선의 차이는 5 mm정도이다. 또한 30, 40과 50 mm의 종양에서는 움직임을 보완하기 위하여 등선량 곡선을 70%정도로 처방할 필요가 있다. 이때의 차이도 약 5 mm 미만이다. 이는 사이버나이프를 이용한 방사선수술 시 움직임 그 차체 보다 여유폭을 적게 줄 수 있다는 의미이며 이는 일반 방사선치료와 다른 점이라 할 수 있다.

만성폐쇄성 폐질환 환자에서 M-mode 초음파로 측정한 횡격막 운동 (M-mode Ultrasound Assessment of Diaphragmatic Excursions in Chronic Obstructive Pulmonary Disease : Relation to Pulmonary Function Test and Mouth Pressure)

  • 임성철;장일권;박형관;황준화;강유호;김영철;박경욱
    • Tuberculosis and Respiratory Diseases
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    • 제45권4호
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    • pp.736-745
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    • 1998
  • 연구배경: 횡격막의 운동은 흉부 단순 촬영과 fluoroscopy로 관찰해 왔으나 근래 초음파에 의해서 횡격막의 운동거리와 두께를 측정하는 연구들이 있어왔다. 초음파 검사의 장점을 살펴보면 간편하고 비침습적이며 방사선조사가 없고 재현성과 정확성이 있다는 점을 들 수 있다. 본 연구에서는 이러한 횡격막 운동 측정에 대한 초음파의 장점을 이용하여 정상인과 만성폐쇄성 폐질환 환자에서 횡격막 운동을 조사하고 그 결과를 폐기능 지표들과 비교하였다. 연구방법: 정상 성인 28례(의과대학생 16례, 나이를 고려한 대조군 12례)와 만성폐쇄성 폐질환 환자 17례를 대상으로 각각에서 폐기능 검사, 최대 흡기압, 최대 호기압과 초음파상 횡격막의 이동 거리를 측정하여 비교하였다. 초음파는 Aloka 사의 KEC-620 모델을 이용하였으며 앙와위 상태에서 환자의 쇄골 중심선에 해당하는 부위의 우상복부에 횡으로 3.5MHz 탐촉자를 대고 간을 에코창으로 이용하여 M-mode 상에서 평상 호흡시와 폐활량 호흡 또는 최대 호흡시의 횡격막 이동 거리를 3회 측정하여 그 평균값을 얻었으며 최대 흡기압과 최대호기압은 Chest사의 Vitalopower KH-101을 이용하여 3회 측정하여 그 평균값을 얻었다. 결 과: 정상인에서의 횡격막 이동거리는 평상호흡에는 1.5cm-1.7cm를 보였고 최대호흡시에는 5.7cm-6.7cm를 보였다. 정상인에서의 최대호흡시에 횡격막 이동거리는 $FEV_1$ $FEV_1/FVC$, PEF, PIF, 신장과 유의한 상관관계를 보였으나 다중 희귀분석에서는 $FEV_1$ 만이 유용한 예측지표로 계산되었다. 만성폐쇄성 폐질환 환자에서의 횡격막 이용거리는 평상호흡시에는 $1.5{\pm}0.6cm$로 정상인과 유의한 차이가 없었으나 최대호흡시에는 $3.7{\pm}1.3cm$로 대조군에 비해 유의하게 감소되어 있었다. 만성폐쇄성 폐질환 환자군의 각 병기에 따라 횡격막 이동거리를 비교해 본 결과 최대호흡시 횡격막의 이동거리는 $FEV_1$이 감소할수록 짧은 경향을 보였으나 통계적 의의는 없었다. 만성폐쇄성 폐질환 환자에서의 최대호흡시에 횡격막 이동거리는 연령, PEmax, %FVC와 유의한 상관관계를 보였으나 다중 회귀분석에서는 최대호기압(PEmax)과 연령이 유의한 예측인자로 계산되었다. 결 론: 만성폐쇄성 폐질환 환자의 횡격막 이동거리는 정상인에 비해 유의하게 감소하였으며 최대호기압과 가장 좋은 상관관계를 보였다. 그러나 만성폐쇄성 폐질환 환자에서 횡격막 이동거리는 $FEV_1$과 유의한 상관관계를 발견할 수 없어서 초음파를 통한 횡격막 운동검사가 폐기능 평가의 또다른 생리적 지표로 이용될 수 있음을 시사하였다.

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스마트폰 다종 데이터를 활용한 딥러닝 기반의 사용자 동행 상태 인식 (A Deep Learning Based Approach to Recognizing Accompanying Status of Smartphone Users Using Multimodal Data)

  • 김길호;최상우;채문정;박희웅;이재홍;박종헌
    • 지능정보연구
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    • 제25권1호
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    • pp.163-177
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    • 2019
  • 스마트폰이 널리 보급되고 현대인들의 생활 속에 깊이 자리 잡으면서, 스마트폰에서 수집된 다종 데이터를 바탕으로 사용자 개인의 행동을 인식하고자 하는 연구가 활발히 진행되고 있다. 그러나 타인과의 상호작용 행동 인식에 대한 연구는 아직까지 상대적으로 미진하였다. 기존 상호작용 행동 인식 연구에서는 오디오, 블루투스, 와이파이 등의 데이터를 사용하였으나, 이들은 사용자 사생활 침해 가능성이 높으며 단시간 내에 충분한 양의 데이터를 수집하기 어렵다는 한계가 있다. 반면 가속도, 자기장, 자이로스코프 등의 물리 센서의 경우 사생활 침해 가능성이 낮으며 단시간 내에 충분한 양의 데이터를 수집할 수 있다. 본 연구에서는 이러한 점에 주목하여, 스마트폰 상의 다종 물리 센서 데이터만을 활용, 딥러닝 모델에 기반을 둔 사용자의 동행 상태 인식 방법론을 제안한다. 사용자의 동행 여부 및 대화 여부를 분류하는 동행 상태 분류 모델은 컨볼루션 신경망과 장단기 기억 순환 신경망이 혼합된 구조를 지닌다. 먼저 스마트폰의 다종 물리 센서에서 수집한 데이터에 존재하는 타임 스태프의 차이를 상쇄하고, 정규화를 수행하여 시간에 따른 시퀀스 데이터 형태로 변환함으로써 동행 상태분류 모델의 입력 데이터를 생성한다. 이는 컨볼루션 신경망에 입력되며, 데이터의 시간적 국부 의존성이 반영된 요인 지도를 출력한다. 장단기 기억 순환 신경망은 요인 지도를 입력받아 시간에 따른 순차적 연관 관계를 학습하며, 동행 상태 분류를 위한 요인을 추출하고 소프트맥스 분류기에서 이에 기반한 최종적인 분류를 수행한다. 자체 제작한 스마트폰 애플리케이션을 배포하여 실험 데이터를 수집하였으며, 이를 활용하여 제안한 방법론을 평가하였다. 최적의 파라미터를 설정하여 동행 상태 분류 모델을 학습하고 평가한 결과, 동행 여부와 대화 여부를 각각 98.74%, 98.83%의 높은 정확도로 분류하였다.

노인의 만성동통 유무에 따른 건강상태 및 일상활동장애 비교 (Comparison of Health Status and Activities for the Pain and No-pain Groups in the Elderly)

  • 김효정;김명애;박경민
    • 농촌의학ㆍ지역보건
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    • 제24권1호
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    • pp.79-89
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    • 1999
  • 본 연구는 동통이 있는 노인 집단과 동통이 없는 노인 집단간의 제 특성, 건강상태와 일상 생활 장애정도와 비교해서 노인 동통관리의 기초자료로 삼고자 시도된 서술적 조사연구였다. 연구대상은 대구시 일부 저소득층 아파트 밀집지역의 가정노인 189명이었고 자료수집기간은 1997년 11월 6일부터 11월 16일까지 였으며 가정 및 복지기관을 방문하여 대상자와 일대일 면접으로 면접자가 직접 기록하였다. 연구도구는 연구자가 국내 외 동통관련문헌을 고찰후 노인의 동통특성을 잘 나타내는 문항을 선택하여 작성하였다. 질문내용은 일반적 특성 7문항, 현재 건강상태에 관한 1문항, 지난 1년간 동통경험유무에 관한 1문항, 동통이 일상생활활동에 미치는 장애에 관한 5문항, 총 14문항으로 구성되었다. 수집된 자료는 SAS Program으로 전산처리 하였으며 동통유무별 인구사회학적 특성을 파악하기 위해 빈도와 백분율을, 동통유무별 건강상태의 차이와 일상생활활동 장애정도의 차이검증을 위해 ${\chi}^2$ 검증을 이용하였다. 1. 전체 대상자수(N=189)에 대해 지난 1년간 동풍을 경험한 대상차 (N=158)의 비율은 83.6%였고 동통 경험이 없는 자(N=31)의 비율은 16.4%였다. 2. 성별 동통호소율은 남자에서 69.5%(N=41), 여자에서 90.0%(N=117)의 분포를 나타내 여자가 남자보다 훨씬 높은 비율을 차지하여 통계적으로 유의한 차이가 있었다.(${\chi}^2$=12.448, df=1, P=.000) 3. 배우자 유무에 있어서는 '유'가 동통호소 집단에서 40.7%인 반면 비동통집단에서 73.3%로 더 많았고 '무'가 비동통집단에서 26.7%인 반면 동통호소집단에서 59.3%로 더 많아 두 집단간 배우자 유무분포에 유의한 차이가 있었다.(${\chi}^2$=10.736, df=1. P=.001) 4. 교육수준은 국문해독가능여부에 따라 '문맹'과 '국문해독가능'으로 측정한 결과 동통호소집단에서 운맹 비율(49.0%)이 높은 반면 비동통집단에서는 국문해독가능한 자의 비율(86.7%)이 더 높아 두 집단간 교육수준분포에는 유의한 차이가 있었다(${\chi}^2$=13.020, df=1, P=.000) 5. 직업에 있어서는 전일제 또는 시간제로 작업을 가지고 있는 경우가 동통호소집단에서 7.0%인 반면 비동통집단에서 32.3%로 직업을 가지지 않은 사함의 비율이 동통호소집단에서 더 높아 두 집단간 유의한 차이가 있었다.(${\chi}^2$=18.807, df=2, P=.000) 6. 주관적인 자신의 건강상태에 대한 분포에서, 동통호소집단은 건강 16.5%임에 비해 불건강은 61.4%이며 비동통집단은 각각 64.5%, 6.5%를 차지해, 동통호소집단에서 불건강호소률이 높아 두 집단간 건강상태에 유의한 차이가 있었다.(${\chi}^2$=40.055, df=1, P=.000) 7. 일상생활 장애정도에 대한 동통호소집단과 비동통집단의 비교에서는 동통호소집단이 비동통호소집단에 비해 활동량 감소율(${\chi}^2$=57.829, df=1, P=.000), 수면장애율(${\chi}^2$=12.785, df=1, P=.000), 근무, 집안일, 용무 등 일상생활을 잘 수행하지 못하는 비율(${\chi}^2$=39.196, df=1, P=.000), 친척이나 친구가 집에 방문했을 때 잘 응대하지 못하는 비율(${\chi}^2$=13.163, df=1, P=.000), 취미생활이나 오락활동과 같은 즐거운 일을 하지 못하게 되는 비율(${\chi}^2$=28.177, df=1, P=.000)이 유의하게 높게 나타났다.

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한국의 지역개발과 댐건설 (Regional Development And Dam Construction in Korea)

  • 안경모
    • 물과 미래
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    • 제9권1호
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    • pp.38-42
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    • 1976
  • Because of differences in thoughts and ideology, our country, Korea has been deprived of national unity for some thirty years of time and tide. To achieve peaceful unification, the cultivation of national strength is of paramount importance. This national strength is also essential if Korea is to take rightful place in the international societies and to have the confidence of these societies. However, national strength can never be achieved in a short time. The fundamental elements in economic development that are directly conducive to the cultivation of national strength can be said to lie in -a stable political system, -exertion of powerful leadership, -cultivation of a spirit of diligence, self-help and cooperation, -modernization of human brain power, and -establishment of a scientific and well planned economic policy and strong enforcement of this policy. Our country, Korea, has attained brilliant economic development in the past 15 years under the strong leadership of president Park Chung Hee. However, there are still many problems to be solved. A few of them are: -housing and home problems, -increasing demand for employment, -increasing demand for staple food and -the need to improve international balance of payment. Solution of the above mentioned problems requires step by step scientific development of each sector and region of our contry. As a spearhead project in regional development, the Saemaul Campaign or new village movement can be cited. The campaign is now spreading throughout the country like a grass fire. However, such campaigns need considerable encouragement and support and the means for the desired development must be provided if the regional and sectoral development program is to sucdceed. The construction of large multipurpose dams in major river basin plays significant role in all aspects of national, regional and sectoral development. It ensures that the water resource, for which there is no substitute, is retained and utilized for irrigation of agricultural areas, production of power for industry, provision of water for domestic and industrial uses and control of river water. Water is the very essence of life and we must conserve and utilize what we have for the betterment of our peoples and their heir. The regional and social impact of construction of a large dam is enormous. It is intended to, and does, dras tically improve the "without-project" socio-economic conditions. A good example of this is the Soyanggang multipurpose dam. This project will significantly contribute to our national strength by utilizing the stored water for the benefit of human life and relief of flood and drought damages. Annual average precipitation in Korea is 1160mm, a comparatively abundant amount. The catchment areas of the Han River, Keum River, and Youngsan River are $62,755\textrm{km}^2$, accounting for 64% of the national total. Approximately 62% of the national population inhabits in this area, and 67% of the national gross product comes from the area. The annual population growth rate of the country is currently estimated at 1.7%, and every year the population growth in urban area increases at a rising rate. The population of Seoul, Pusan, and Taegu, the three major cities in Korea, is equal to one third of our national total. According to the census conducted on October 1, 1975, the population in the urban areas has increased by 384,000, whereas that in rural areas has decreased by 59,000,000 in the past five years. The composition of population between urban and rural areas varied from 41%~59% in 1959 to 48%~52% in 1975. To mitigate this treand towards concentration of population in urban areas, employment opportunities must be provided in regional and rural areas. However, heavy and chemical industries, which mitigate production and employment problems at the same time, must have abundant water and energy. Also increase in staple food production cannot be attained without water. At this point in time, when water demand is rapidly growing, it is essential for the country to provide as much a reservoir capacity as possible to capture the monsoon rainfall, which concentarated in the rainy seaon from June to Septesmber, and conserve the water for year round use. The floods, which at one time we called "the devil" have now become a source of immense benefit to Korea. Let me explain the topographic condition in Korea. In northern and eastern areas we have high mountains and rugged country. Our rivers originate in these mountains and flow in a general southerly or westerly direction throught ancient plains. These plains were formed by progressive deposition of sediments from the mountains and provide our country with large areas of fertile land, emminently suited to settlement and irrigated agricultural development. It is, therefore, quite natural that these areas should become the polar point for our regional development program. Hower, we are fortunate in that we have an additional area or areas, which can be used for agricultural production and settlement of our peoples, particularly those peoples who may be displaced by the formation of our reservoirs. I am speaking of the tidelands along the western and southern coasts. The other day the Ministry of Agriculture and Fishery informed the public of a tideland reclamation of which 400,000 hectares will be used for growing rice as part of our national food self-sufficiency programme. Now, again, we arrive at the need for water, as without it we cannot realize this ambitious programme. And again we need those dams to provide it. As I mentioned before, dams not only provide us with essential water for agriculture, domestic and industrial use, but provide us with electrical energy, as it is generally extremely economical to use the water being release for the former purposes to drive turbines and generators. At the present time we have 13 hydro-electric power plants with an installed capacity of 711,000 kilowatts equal to 16% of our national total. There are about 110 potential dams ites in the country, which could yield about 2,300,000 kilowatts of hydro-electric power. There are about 54 sites suitable for pumped storage which could produce a further 38,600,000 kilowatts of power. All available if we carefully develop our water resources. To summarize, water resource development is essential to the regional development program and the welfare of our people, it must proceed hand-in-hand with other aspects of regional development such as land impovement, high way extension, development of our forests, erosion control, and develop ment of heavy and chemical industries. Through the successful implementation of such an integrated regional development program, we can look forward to a period of national strength, and due recognition of our country by the worlds societies.

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『황제내경소문(黃帝內經素問)·칠편대론(七篇大論)』 왕빙 주본(注本)을 통(通)한 운기학설(運氣學說) 관(關)한 연구(硏究)

  • 김기욱;박현국
    • 동국한의학연구소논문집
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    • 제4권
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    • pp.109-140
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    • 1995
  • As we considered in the main subjects, investigations on the theory of 'Doctrine on five elements' motion and six kinds of natural factors(運氣學說)' through 'Wang Bing's Commentary(王氷 注本)' of 'The seven great chapters in The Yellow Emperor's Internal Classic Su Wen' ("黃帝內經素問 七篇大論") are as follows. (1) In The seven great chapters("七篇大論")' Wang Bing supplement theory and in the academic aspects as a interpreter, judging from 'forget(亡)' character. expressed in the 'The missing chapters("素問遺篇")', 'Bonbyung-ron("本病論")' and 'Jabeob-ron(刺法論)', 'The seven great chapters("七篇大論")' must be supplementary work by Wang Bing. Besides, he quoted such forty books as medical books, taoist books, confucianist books, miscellaneous books, etc in the commentary and the contents quoted in the 'Su Wen(素問)' and 'Ling Shu("靈樞")' scripture nearly occupy in the book. As a method of interpreting scripiure as scripture, he edited the order of 'Internal Classic("內經")' ascended from the ancient time and when he compensated for commentary, with exhaustive scholarly mind and by observing the natural phenomena practically and writing the pathology and the methods of treatment. We knew that the book is combined with the study of 'Doctrine on five elements motion and six kinds of natural factors(運氣學說)' (2) When we compare, analyze the similar phrase of 'The seven great chapters in The Yellow Emperor's Internal Classic Su Wen'("黃帝內經素問ㆍ七篇大論") through 'Wang Bing's Commentary(王氷 注本)', he tells abouts organized 'five elements(五行)' and 'heaven's regularly movement(天道運行)' rather than 'Emyangengsangdae-ron("陰陽應象大論")' in 'The seven great chapters("七篇大論")'. Also the 'Ohanunhangdae-ron("五運行大論")' because the repeated sentences with 'Emyangengsangdae-ron("陰陽應象大論")' is long they are omitted. And in the 'Youkmijidae-ron("六微旨大論")', 'Cheonjin ideology(天眞四象)' based on the 'Sanggocheonjin- ron("上古天眞論")', 'Sagijosindae-ron("四氣調神大論")' is written and in the 'Gigoupyondae-ron("氣交變大論")', the syndrome and symptom are explained in detail rather than 'Janggibeobsi-ron("藏氣法時論")', 'Okgijinjang-ron ("玉機眞藏論")' and in the 'Osangieongdae-ron("五常政大論")', the concept of 'five element(五行)' of the 'Gemgwejineon-ron("金櫃眞言論")' is expanded to 'the five elements' motion concept(五運槪念)' and in the 'Youkwonjeonggidae-ron("六元正紀大論")', explanations of 'The five elements' motion and six kinds of natural factors(運氣)' function are mentioned mainly and instead systematic pathology is not revealed rather than 'Emyangengsangdae-ron("陰陽應象大論")'. And in the 'Jijinyodae-ron("至眞要大論")', explanations of the change of atmosphere which correspond to treatment principle by 'The three Yin and Yang(三陰三陽)' as a progressed concepts are revealed. Therefore there are much similarity between the phrase of 'Emyangengsangdae-ron("陰陽應象大論")' and 'chapters of addition(補缺之篇)'. Generally, the doctrine which 'The seven great chapters("七篇大論")' are added by Wang Bing(王氷) is supported because there are more profound concepts rather than the other chapter in 'The seven great chapters("七篇大論")'. (3) When we study Wang Bing's(王氷) 'Pattern on five elements motion and six kinds of natural factors(運氣格局)' in 'The seven great chapter("七篇大論")', in the 'Cheonwongi-dae-ron("天元紀大論")', With 'Cheonjin ideology(天眞思想)' and the concepts of 'Owang(旺)'${\cdot}$'Sang(相)'${\cdot}$'Sa(死)'${\cdot}$'Su(囚)'${\cdot}$'Hu(休)' and 'Cheonbu(天符)'${\cdot}$'Sehwoi(歲會)' are measured time-spacially to the concept of 'Three Sum(三合)' the concept of 'Taeulcheonbu(太乙天符)' is explained. In the 'Ounhangdae-ron("五運行大論")', 'The calender Signs five Sum(天干五合)' is compared to the concepts of 'couples(夫婦)', 'weak-strong(柔强)' and in the 'Youkmijidae-ron("六微旨大論")', 'the relationship of obedience and disobedience(順逆關係)' which conform to the 'energy status(氣位)' change and 'monarch-minister(君相)' position is mentioned. In the 'Gikyobyeondae-ron("氣交變大論")', the concept of 'Sang-duk(相得)', 'Pyungsang(平常)' is emphasized but concrete measurement is mentioned. In the 'Osangieongdae-ron("五常政大論")', the detailed explanation with twenty three 'systemic of the five elements' motion(五運體系)' form and 'rountine-contrary treatment(正治. 反治)' with 'chill-fever-warm-cold(寒${\cdot}$${\cdot}$${\cdot}$凉)' are mentioned according to the 'analyse and differentiate pathological conditions in accordance with the eight principal syndromes(八綱辨證)'. In the 'Youkwonjeonggidae-ron("六元正紀大論")', Wang Bing of doesn't mention the concepts of 'Jungwun(中運)' that is seen in the original classic. In the new corrective edition, as the concepts of 'Jungwun, Dongcheonbu, Dongsehae and Taeulcheonbu(中運, 同天符, 同歲會, 太乙天符)' is appeared, Wang Bing seems to only use the concepts of 'Daewun, Juwun, and Gaekwun(大運, 主運, 客運)'. In the 'Jijinyodaeron("至眞要大論")', Wang Bing added detailed commentary to pathology and treatment doctrine by explaining the numerous appearances of 'Sebo, sufficiency, deficiency(歲步, 有餘, 不足)' and in the relation of 'victory-defeat(勝復)', he argued clearly that it is not mechanical estimation. (4) When we observe the Wang Bing's originality on the study of 'the theory of Doctrine on five elements' motion and six kinds of natural factors(運氣學說)', he emphasized 'The idea of Jeongindogi and Health preserving(全眞導氣${\cdot}$養生思想)' by adding 'Wang Bing's Commentary(王氷 注本)' of 'The seven great chapters("七篇大論")' and explained clearly 'The theory of Doctrine on five elements' motion and six kinds of natural factors(運氣學說)' and simpled and expanded the meaning of 'man, as a microcosm, is connected with the macrocosm(天人相應)' and with 'Atmosphere theory(大氣論)' also explained the meaning of 'rising and falling mechanism(升降氣機)'. In the sentence of 'By examining the pathology, take care of your health(審察病機 無失氣宜)'. he explained the meaning of pathology of 'heart-kidney-water-fire(心腎水火)' and suggested the doctrine and management of prescription. In the estimation and treatment, by suggesting 'asthenia and sthenia(虛實)' two method's estimation, 'contrary treatment(反治)' and treatment principals of 'falling heart fire tonifyng kidney water(降心火益腎水)', 'two class of chill and fever(寒熱二綱)' were demonstrated. There are 'inside and outside in the illness and so inner and outer in the treatment(病有中外 治有表囊)'. This sentence suggests concertedly. 'two class of superfies and interior(表囊二綱)' conforming to the position of disease. Therefore Wang Bing as an excellent theorist and introduced 'Cheoniin ideology(天眞思想)' as a clinician and realized the medical science. With these accomplishes mainly written in 'The theory of Doctrine on five elements' motion and six kinds of natural factors(運氣學說)' of 'The seven great chapters("七篇大論")', he interpreted the ancient medical scriptures and expanded the meaning of scriptures and conclusively contributed to the development of the study 'Korean Oriental Medicine(韓醫學)'.

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일본(日本) 의학(醫學)의 '절충파(折衷派)'에 관(關)한 연구(硏究) (A Study on the ' Zhe Zhong Pai'(折衷派) of the Traditional Medicine of Japan)

  • 박현국;김기욱
    • 동국한의학연구소논문집
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    • 제10권
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    • pp.41-61
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    • 2008
  • The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai(古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai' viewed treatments as the base, which was the view of most doctors in the Edo period. However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up'(兼收並蓄) was the same as the 'Kao Zheng Pai'. Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷). Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡). Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows. First Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方)' and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan(導水瑣言)", "Jiao Chiang Fang Yi Je(蕉窗方意解)" and "Yi Xue Sho(醫學說)". Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshimasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong Jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言)". Third, Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao Jing(神農本草經)", the main text for herbal medicine, "Ming Tang Jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei Jing(皇帝內經)" and "Nan Jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong Zong(中村中倧) and learned 'the old way'(古方) from Yoshimasu Todo and got experience through Ouan Yue(川越) and Fu Jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) fmm famous teachers. Showhaku(倧伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and receives help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue Gu(小島學古) and Xi Duo Cun Kao(喜多村栲窻) and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衡心) and becomes a Zheng Shi(徵土), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) Jia Ren Qn Wang(嘉仁親王, later the 大正天皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the qualjty and quantity of his clinical skills. Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窻書影)", "Wu Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "Jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窻書影) he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking, In the first volume of "Shang Han Biang Shu(傷寒辨術)" and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.

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간질성 폐질환환자들의 기관지 폐포세척액내 폐포 대식세포와 임파구의 접착분자 발현 및 Soluble ICAM-1 농도에 관한 연구 (The Expression of Adhesion Molecules on Alveolar Macrophages and Lymphocytes and Soluble ICAM-1 Level in Serum and Bronchoalveolar Lavge(BAL) Fluid of Patients with Diffuse Interstitial Lung Diseases(DILD))

  • 김동순;최강현;염호기;박명재;임채만;고윤석;김우성;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제42권4호
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    • pp.569-583
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    • 1995
  • 연구배경: 간질성 폐질환은 여러가지 다양한 원인에 의해, 또는 아직 밝혀지지 않은 원인에 의해 폐포염 및 폐간질내 염증으로 시작해 종국에는 폐섬유증으로 진행되는 질환들로 염증세포들의 이동에 필요한 접착분자들이 이들 질환의 발병기전에 중요한 역할을 할 것으로 추정되며, 현재까지는 뚜렷이 적당한 지표가 없었던 질환의 활동성을 판정하는 지표로 사용할 수 있을 가능성이 많다. 그러나 이제까지는 BAL내 AM에서 면역염색법으로 측정한 결과들로 방법 자체가 음성과 양성세포를 감별하기가 쉽지 않을 뿐 아니라 발현도 증가를 정량적으로 측정하지 못하는 단점이 있고, 따라서 발표된 결과들이 차이가 많다. 저자들은 간질성 폐질환 환자들에서 기관지 폐포세척액(BAL)내 AM과 임파구에서의 ${\beta}_2$-integrin(CD18)과 ICAM-1의 발현도를 FACS를 이용한 relative median fluorescence intenity(RMFI)를 측정하여 정상 대조군과 비교 관찰하고, 또한 혈청 및 BAL액내 가용정 ICAM-1(sICAM-1) 농도를 측정하고, BAL액내 다른 지표들과 비교하여 이들을 간질성 폐질환의 활성도를 반영할 수 있는 지표로 사용할 가능성을 알아 보았다. 방법: 대상은 조직학적으로 확인 된 미만성 간질성 폐섬유증(IPF) 환자 11명, 교원성 폐질환과 연관된 폐섬유증환자(CVD-PF) 6명, 폐유육종증 9명, 과민성 폐장염환자 2명과 대조군으후 건강한 정상인 9명이었고 BAL은 통상적인 방법을 사용하였다. ICAM-1 및 CD18은 단일항체를 사용하여 FACScan으로 median fluorescence intenity를 측정하여 RMFI를 구하고, sICAM-1농도는 ELISA법으로 측정하였다. 결과: AM에서 ICAM-1의 발현도는 $3.30{\pm}1.16$으로 대조군($0.93{\pm}0.18$)보다 증가되었고 임파구의 ICAM-1 발현도 $5.39{\pm}2.70$으로 대조군($1.06{\pm}0.21$)보다 높았다. CD18의 발현도는 임파구에서 $24.9{\pm}14.9$로 대조군($4.69{\pm}3.77$) 보다 향진되었으며, 이들 ICAM-1의 발현도는 AM 백분률과 역상관관계륜 보였고(r=-0.66, p=0.0001) 임파구의 백분율과는 정상관관계를 보였다(r=0.447, p=0.0116). 임파구가 증가되는 유육종증, 교원성질환, 과민성폐렴에서는 임파구의 ICAM-1 발현도와 BAL액내 임파구의 %(r=0.747, p=0.0006) 및 임파구농도(r=0.832, p=0.0002)와 좋은 상관관계를 보였고, 임파구의 IL-2수용체발현과도 연관관계를 나타내었다(r=0.539, p=0.0075). 또한 유육종증에서는 혈중 ACE 농도와 임파구의 ICAM-1 발현도가(r=0.905, p=0.0132) 높은 상관관계를 보여, 이들 접착분자 발현도가 병소의 활동성과 연관이 있음을 시사 하였다. 혈청내 sICAM-1농도는 환자군에서 $499.7{\pm}222.2\;ng/ml$로 대조군의 $199.0{\pm}38.9\;ng/ml$보다 높았으며(p=0.0097), BAL액내 sICAM-1농도도 환자군에서 $41.8{\pm}23.0\;ng/ml$로 대조군의 $20.1{\pm}13.6\;ng/ml$보다 증가를 보였다. 또한 혈청내 sICAM-1 농도는 AM의 ICAM-1 발현도 및 (r=0.554, p=0.0259) BAL액내 sICAM-1농도와 상관관계를 보였다. 또한 혈청 및 BAL액내의 albumin과 sICAM-1의 비율을 비교한 결과 BAL액내의 sICAM-1 농도가 훨씬 높은 것으로 미루어 대부분의 sICAM-1은 병소내에서 생성된 것임을 짐작할 수 있었다. 결론: 간질성폐질환환자들의 AM및 BAL-임파구에서 접착분자들의 발현도가 증가되었고, 혈청 및 BAL액내 sICAM-1 농도가 상승되어 있어 이들 접착분자들이 발병기전에 중요한 역할을 한다고 생각되며, 앞으로 이 활동성 판정의 지표로 사용할 기능성을 시사하였다.

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일본(日本) 의학醫學의 '절충파(折衷派)'에 관(關)한 연구(硏究) (A Study on the 'Zhe Zhong Pai'(折衷派) of the Traditional Medicine of Japan)

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제20권3호
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    • pp.121-141
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    • 2007
  • The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai (古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai ' viewed treatments as the base, which was the view of most doctors in the Edo period, However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up' was the same as the 'Kao Zheng Pai', Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷), Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡), Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows First. Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方), and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan", "Jiao Chiang Fang Yi Je" and "Yi Xue Sho(醫學說)" Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshirnasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言) Third. Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao jing(神農本草經)", the main text for herbal medicine, "Ming Tang jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei jing(黃帝內徑)" and "Nan jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong(中村中倧) and learned 'the old way'(古方) from Yoshirnasu Todo and got experience through Chuan Yue(川越) and Fu jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) from famous teachers. Showhaku(宗伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and recieves help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue GU(小島學古) and Xi Duo Cun Kao Chuang and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衝心) and becomes a Zheng Shi(徵I), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) jia Ren Qn Wang(嘉仁親王, later the 大正犬皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the quality and quantity of his clinical skills Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窓書影)", "WU Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窓書影)" he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking. In the first volume of "Shung Han Biang Shu(傷寒辨術) and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.

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정위적체부방사선치료시 ExacTrac과 CBCT를 이용한 Combine IGRT의 유용성 평가 (Evaluation of Combine IGRT using ExacTrac and CBCT In SBRT)

  • 안민우;강효석;최병준;박상준;정다이;이건호;이두상;전명수
    • 대한방사선치료학회지
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    • 제30권1_2호
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    • pp.201-208
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    • 2018
  • 목 적 : 본 연구에서는 정위적체부방사선치료시 ExacTrac과 CBCT를 단계적으로 적용한 Combine IGRT를 사용하여 Set-up 오차를 비교 및 분석하여 Combine IGRT의 유용성을 평가하고자 한다. 대상 및 방법 : 2014년 5월에서 2017년 11월까지 본원에 내원하여 trueBEAM Stx(Varian medical System, USA)에서 정위적체부방사선치료를 받은 환자 중 부위별로 뇌(Brain) 3명, 척추(Spine) 9명, 골반(Pelvis) 3명으로 분류하였다. 치료전 ExacTrac을 사용하여 Lateral(Lat), Longitudinal(Lng), Vertical(Vrt) 방향과 Roll, Pitch, Yaw 방향으로 Set-up 오차를 보정하였고, ExacTrac 이동 값을 적용 후 CBCT를 추가적으로 수행하여 Lat, Lng, Vrt, Rotation(Rtn) 방향으로 보정하였다. 결 과 : ExacTrac 사용시 뇌 부위의 오차는 Lat $0.18{\pm}0.25cm$, Lng $0.23{\pm}0.04cm$, Vrt $0.30{\pm}0.36cm$, Roll $0.36{\pm}0.21^{\circ}$, Pitch $1.72{\pm}0.62^{\circ}$, Yaw $1.80{\pm}1.21^{\circ}$, 척추 부위는 Lat $0.21{\pm}0.24cm$, Lng $0.27{\pm}0.36cm$, Vrt $0.26{\pm}0.42cm$, Roll $1.01{\pm}1.17^{\circ}$, Pitch $0.66{\pm}0.45^{\circ}$, Yaw $0.71{\pm}0.58^{\circ}$, 골반 부위는 Lat $0.20{\pm}0.16cm$, Lng $0.24{\pm}0.29cm$, Vrt $0.28{\pm}0.29cm$, Roll $0.83{\pm}0.21^{\circ}$, Pitch $0.57{\pm}0.45^{\circ}$, Yaw $0.52{\pm}0.27^{\circ}$로 나타났다. Couch 이동 후 CBCT를 하였을 때, 뇌 부위는 Lat $0.06{\pm}0.05cm$, Lng $0.07{\pm}0.06cm$, Vrt $0.00{\pm}0.00cm$, Rtn $0.0{\pm}0.0^{\circ}$, 척추 부위는 Lat $0.06{\pm}0.04cm$, Lng $0.16{\pm}0.30cm$, Vrt $0.08{\pm}0.08cm$, Rtn $0.00{\pm}0.00^{\circ}$, 골반 부위는 Lat $0.06{\pm}0.07cm$, Lng $0.04{\pm}0.05cm$, Vrt $0.06{\pm}0.04cm$, Rtn $0.0{\pm}0.0^{\circ}$ 오차가 발생하였다. 결 론 : 정위적체부방사선치료시 ExacTrac에 추가적으로 CBCT를 사용한 Combine IGRT의 경우는 ExacTrac만 사용한 경우보다 환자의 Set-up 오차를 줄일 수 있게 나타났다. 그러나 Combine IGRT를 적용함으로 환자 Set-up 확인시간, 영상획득을 위한 체내 흡수선량이 증가한다. 그러므로 환자 상황에 따라 Combine IGRT를 사용하여 환자의 Set-up 오차를 적게 함으로써 방사선치료 효과비를 증가시킬 수 있을 것으로 사료된다.

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