• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.81-90
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• 2017

Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권4호
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• pp.29-38
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• 2020

Purpose: The first thing to be done in promoting community care is local diagnosis. Therefore, this study attempted to derive the physical infrastructure to be diagnosed, and to develop diagnostic items and diagnostic indicators applicable to this. Methods:: First, the physical infrastructure related to the community care is derived. And the diagnosis items are derived using the checklist of 'community support and health services' in the WHO Guide for Global age-friendly cities. Next, by analyzing previous studies, we develop diagnostic indicators for each diagnostic item and explore their applicability. Results: As a result of deriving the physical infrastructure for each area of housing, health service, and nursing care for community care, 22 facilities were derived for 9 types. Diagnosis items for the facilities are 1)regional equity, 2)proximity between facilities, 3)transportation access, 4)regional use, 5)barrier-free design, 6)diversity of facilities, and a total of 14 diagnostic indicators was derived. We reviewed and suggested the applicability of diagnostic items and indicators by each physical infrastructure. Implications: For the realization of community care, local diagnosis should not be limited to sim- ply grasping the presence or absence of facilities and the total amount. Instead it should strengthen capabilities by conducting diagnosis to understand the performance of facilities.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1355-1366
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• 2020

Objective: We aimed to evaluate the diagnostic value and prognostic relevance of FDG positron emission tomography/computed tomography (PET-CT) in extrahepatic cholangiocarcinoma patients. Materials and Methods: This study included 234 extrahepatic cholangiocarcinoma patients who underwent FDG PET-CT between June 2008 and February 2016. The diagnostic performance of FDG PEG-CT was compared to that of contrast-enhanced multidetector row CT (MDCT) and MRI. Independent prognosticators for poor survival were also assessed. Results: The sensitivity of FDG PET-CT for detecting primary tumor and regional lymph node metastases was lower than that of MDCT or MRI (p < 0.001), whereas the specificity and positive predictive value for detecting regional lymph nodes metastases was significantly better in FDG PET-CT compared to MDCT and MRI (all p < 0.001). There was no significant difference in the diagnostic yield of distant metastases detection among three diagnostic imaging techniques. In a multivariate analysis, maximum standardized uptake values (SUV_max) of the primary tumor (adjusted hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.13-2.69) and of the metastatic lesions ≥ 5 (adjusted HR, 8.10; 95% CI, 1.96-33.5) were independent contributors to poor overall survival in extrahepatic cholangiocarcinoma patients. In a subgroup analysis of 187 patients with periductal infiltrating type of cholangiocarcinoma, an SUV_max of the primary tumor ≥ 5 was associated with an increased risk of regional lymph node (adjusted odds ratio [OR], 1.60; 95% CI, 0.55-4.63) and distant metastases (adjusted OR, 100.57; 95% CI, 3.94-2567.43) at diagnosis as well as with poor overall survival (adjusted HR, 1.81; 95% CI, 1.04-3.15). Conclusion: FDG PET-CT showed lower sensitivity for detecting primary tumor and regional lymph node involvement than MDCT and MRI. However, the SUV_max of primary tumors and metastatic lesions derived from FDG PET-CT could have significant implications for predicting prognoses in extrahepatic cholangiocarcinoma patients.

• Annals of Clinical Neurophysiology
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• 제24권2호
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• pp.35-45
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• 2022

Complex regional pain syndrome (CRPS) is a chronic regional pain disorder that most frequently affects the limbs. It is characterized by hyperalgesia, allodynia, edema, motor disturbance, and vasomotor instability, and typically occurs following surgery or trauma. In type-I CRPS there is no confirmed nerve injury, while peripheral nerve injury is present in type-II CRPS. The multifactorial pathophysiological etiology of CRPS includes inflammation, autoimmune responses, abnormal cytokine production, autonomic dysfunction, altered blood flow, psychological factors, and central cortical reorganization. There are no specific laboratory diagnostic tools for CRPS, and so it is diagnosed clinically. The Budapest criteria are currently the most-accepted diagnostic criteria.

• 농촌계획
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• 제27권1호
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• pp.9-20
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• 2021

In order to develop practical indicator that can diagnose the regional conditions and characteristics of fishing villages, this study reviewed domestic and foreign researches and selected the diagnostic indicator of fishing villages by spatial unit. The major categories are divided into population and society, economic conditions, and living conditions. The middle categories consists of population, household, industry, tourism, settlement, environment, safety, health and welfare, education, and culture and leisure. The indicator were selected with reference to the existence of statistical data officially provided according to the spatial range(Si/Gun, eup/myeon, village). Based on the selected indicator, the test evaluation was conducted in Jindo-gun, Jeollanam-do by applying data that can be obtained from KOSIS and web GIS. It is judged that the diagnostic indicator developed through this research can be used in various ways from the planning stage to the implementation stage of the regional development project, such as grasping the current conditions, setting improvement targets, promotion and evaluation/monitoring of the project. In addition, it is expected that it will be possible to carry out regional diagnosis for each spatial unit and to plan and implement regional development projects by giving priority to areas where the level of each department is insufficient.

• 농촌계획
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• 제27권2호
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• pp.91-104
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• 2021

The purpose of this study is to develop the diagnostic indices system that can be applied to the evaluation of rural village level, because the indicators developed in many existing studies were mostly consisted of statistical data in higher level than rural villages as well as those were difficult to apply to rural village level empirically. In order to develop the empirical diagnostic indices system, which has 52 indices with 7 categories, this study not only classified the kind of rural village facility and the regional development project of government, but also surveyed the specialist opinion with Delphi method. Especially, this study standardized the all diagnostic indices with positive value to remove the indices with negative values. Finally, the results that the study applied the empirical diagnostic indices to the 15 sample villages of Jinan-gun and Cheongyang-gun showed that there was the applicability of the indices system in the village level.

• The Korean Journal of Pain
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• 제22권2호
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• pp.146-150
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• 2009

Background: A skin temperature difference is one of the variables used in the diagnosis of complex regional pain syndrome. However, there have been no reports as to whether the real (${\Delta}T$) or absolute value ($|{\Delta}T|$) of skin temperature differences should be used in the diagnosis of complex regional pain syndrome. This study was conducted to compare the diagnostic validity of ${\Delta}T$ with $|{\Delta}T|$ for complex regional pain syndrome using receiver operating characteristic curves (ROC). Methods: Infrared thermographic images were obtained from the 144 patients who were suspected to have CRPS in a unilateral limb. After ${\Delta}T$ and $|{\Delta}T|$ calculation from the thermographic image, ROCs of ${\Delta}T$ and $|{\Delta}T|$ were developed, and the areas under the curve (AUC) for the ROC curves were compared. Results: AUCs of ${\Delta}T$ and $|{\Delta}T|$ were 0.520 and 0.746 respectively, this difference was statistically significant (P < 0.001). Conclusions: Absolute skin temperature difference shows greater validity in the diagnosis of CRPS than ${\Delta}T$. Therefore, $|{\Delta}T|$ is more useful when comparing the skin temperature of CRPS patients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권1호
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• pp.23-30
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• 2022

Purpose: Health examination centers of regional public hospitals are essential facilities for strengthening preventive medical services in local communities. This study is to organize architectural planning data related to function, space, and area composition of health examination center by the size of the regional public hospitals. Methods: The literature review on the function and spatial composition of the health examination center and the drawings of the regional public hospitals were analyzed. Results: The result of this study can be summarized into several points. 1) The function of the health examination center consists of a diagnostic area, patient area, and staff area based on general examination and comprehensive examination. 2) The type of spatial composition of the 300-bed public hospital examination center is a spatial linkage type with examination rooms of the other departments where general examination and comprehensive examination are undifferentiated. 3) The examination center of public hospitals with 500 beds or more is composed of an independent space-separated type with self-installed examination rooms, and general examination and comprehensive examination are divided. 4) The examination center of public hospitals with 300 beds around, the diagnostic area occupies most of the total area, around 80%, but in public hospitals with 500 beds or more, the proportion of diagnostic area drops to 50-60%, and patient area increases to 30-40%. Implications: The examination center planning of public hospitals requires an architectural planning approach to the function and spatial composition according to the size of the hospital.

• 대한핵의학회지
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• 제22권2호
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• pp.163-170
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• 1988

8 patients of delayed CO sequelae were evaluated using Brain CT and $^{99m}Tc-HMPAO$ SPECT. The results were as follows; 1) CT findings of delayed CO sequleae were bilateral low density lesion in globus pallidus (l pt.), diffuse low density in white matter with bilateral low density in white matter (l pt.), diffuse low density in white matter with bilateral low density in globus pallidus (l pt.), diffuse low density in white matter with cortical atrophy (l pt.), bilateral low density in globus pallidus and diffuse low density in white matter with cortical atrophy (l pt.) and normal in 3 pts. 2) $^{99m}Tc-HMPAO$ Brain SPECT findings of delayed CO sequelae were decreased regional cerebral blood flow (rCBF) in frontal (1 among 8 pts.), frontal and basal ganglia (3 among 8 pts.), and diffuse patch decreased rCBF pattern (4 among 8 pts.) 3) $^{99m}Tc-HMPAO$ Brain SPECT study was well correlated with neurologic symptoms and signs in delayed CO sequelae. Our results may suggest that reduced cerebral blood flow contributes to the development of delayed CO sequelae.

• 대한핵의학회지
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• 제26권1호
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• pp.33-39
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• 1992

Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.