• 대한핵의학회지
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• 제37권3호
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• pp.137-146
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• 2003

Rheumatic diseases can be categorized by pathology into several specific types of musculoskeletal problems, including synovitis (e.g. rheumatoid arthritis), enthesopathy (e.g. ankylosing spondylitis) and cartilage degeneration (e.g. osteoarthritis). Skeletal radiographs have contributed to the diagnosis of these articular diseases, and some disease entities need typical radiographic changes as a factor of the diagnostic criteria. However, they sometimes show normal radiographic findings in the early stage of disease, when there is demineralization of less than 30-50 %. Bone scans have also been used in arthritis, but not widely because the findings are nonspecific and it is thought that bone scans do not add significant information to routine radiography. Bone scans do however play a different role than simple radiography, and it is a complementary imaging method in the course of management of arthritis. The Image quality of bone scans can be improved by obtaining regional views and images under a pin-hole collimator, and through a variety of scintigraphic techniques including the three phase bone scan and bone SPECT. Therefore, bone scans could improve the diagnostic value, and answer multiple clinical questions, based on the pathophysiology of various forms of arthritis.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.252-265
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• 2021

Cardiac magnetic resonance imaging (MRI) serves as a clinical gold-standard non-invasive imaging technique for the assessment of global and regional cardiac function. Conventional cardiac MRI is limited by the long acquisition time, the need for ECG gating and/or long breathhold, and insufficient spatiotemporal resolution. Real-time cardiac cine MRI refers to high spatiotemporal cardiac imaging using data acquired continuously without synchronization or binning, and therefore of potential interest in overcoming the limitations of conventional cardiac MRI. Novel acquisition and reconstruction techniques must be employed to facilitate real-time cardiac MRI. The goal of this study is to discuss methods that have been developed for real-time cardiac MRI. In particular, we classified existing techniques into two categories based on the use of non-iterative and iterative reconstruction. In addition, we present several research trends in this direction, including deep learning-based image reconstruction and other advanced real-time cardiac MRI strategies that reconstruct images acquired from real-time free-breathing techniques.

• 농촌계획
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• 제27권4호
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• pp.109-122
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• 2021

The purpose of this study is to develop a application procedure and survey method for the empirical diagnostic indices system. In order to know the survey method, which has 65 investigation items for 52 indicators, this study not only presented so that the each survey items could be surveyed in at least 1 to 3 steps, but also presented the 4 survey method for each investigation items: preliminary survey, administrative survey, field survey, and interview survey. As a result of applying to 15 sample villages, the period of surveying a village of 100 households was 1.4 days, and it was confirmed that the survey was generally efficient in a short time. As a result of applying the survey system to the sample village, the developed survey system showed the possibility of investigating even the details of rural villages. Therefore, it was judged that it could be used as a basic procedure for a rural village unit survey.

• 한국수학교육학회지시리즈C:초등수학교육
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• 제16권2호
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• pp.163-182
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• 2013

최근 몇 년간 국가수준에서 학생들의 기초학력 향상을 위한 다양한 정책이 수행되었다. 2011년 초등학교 3학년 기초학습 진단평가는 학생들의 학습부진을 조기에 확인하고 그에 따른 보정 교육을 실시할 목적으로 실시되었다. 본 연구에서는 초등학교 3학년 기초학습 진단평가 기초수학의 평가 결과를 토대로 초등학교 3학년 학생들의 성취수준을 분석하였고, 성취수준별 학생들의 학업성취도를 분석하였으며, 3) 학생들의 반응이 특이한 문항 분석을 실시하였다.

• Tuberculosis and Respiratory Diseases
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• 제75권3호
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• pp.104-110
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• 2013

Background: Osteopontin (OPN) and carbonic anhydrase IX (CAIX), which are expressed on the surface of tumor cells, are associated with hypoxia during tumor development and progression. However, the roles of these proteins in the plasma of patients with non-small cell lung cancer (NSCLC) are poorly understood. Herein, we hypothesized that plasma OPN and CAIX levels could be used as diagnostic and prognostic tumor markers in patients with NSCLC. Methods: Fifty-three patients with NSCLC and 50 healthy control subjects were enrolled. We selected controls without malignancy and matched them with NSCLC patient cases according to age and gender. Blood samples were collected at the time of diagnosis; the plasma levels of OPN and CAIX were measured by enzyme-linked immunosorbent assays. Results: The plasma levels of OPN in the patients with NSCLC were significantly elevated as compared to those in the controls (p=0.016). However, there was no difference in the plasma level of CAIX between the NSCLC patients and controls. NSCLC patients with a distant metastasis had a remarkable increase in plasma OPN compared with patients without metastasis (p=0.026), but no such correlation was found for CAIX. There was no difference in overall survival rates according to the plasma level of OPN between the two groups (by Kaplan-Meier survival analysis). Conclusion: Plasma OPN levels were elevated in patients with NSCLC as compared with the controls, with greater elevation of OPN levels in the advanced stages of disease. Therefore, plasma OPN may have utility as a diagnostic, but not prognostic, biomarker of advanced NSCLC.

• 대한방사선기술학회지:방사선기술과학
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• 제32권1호
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• pp.39-43
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• 2009

전리방사선을 이용한 의료진단검사는 장치의 발전과 더불어 환자의 삶을 개선시키고 의료검사의 혁명을 가지고 왔다. 하지만 이러한 의료영상의 발전은 대중에 의한 전리방사선피폭의 증가의 원인이 되었다. 이러한 가운데 ICRP에서는 각 국가 및 지역의 실정에 맞게 진단참고준위를 사용하도록 권고하고 있으며, 우리나라에서도 2007년 식품의약품안전청에서 환자선량측정 가이드라인을 제시하였다. 하지만 임상에서는 대부분 선량계가 없어 X선 검사시 환자피부선량을 알 수가 없는 것이 현실이다. 이에 저자는 bit system을 이용하여, PC상에서 엑셀프로그램을 이용하여 간단하게 환자선량을 알 수 있게 프로그램화 하여 그 유용성을 검토하였으며, 그 결과 실측값과 계산값은 약 10% 정도의 차이로 우수한 결과를 나타내었다.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.342-349
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• 2015

Background : Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system. Method : A retrospective single-center analysis was undertaken of all consecutive patients who underwent chemical thrombolysis and mechanical thrombectomy using Penumbra or Solitaire stent retriever from March 2009 to March 2014. Baseline characteristics, rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b-3), symptomatic intracerebral hemorrhage, procedure time, mortality and independent functional outcomes ($mRS{\leq}2$) at 3 month were compared across the three method. Results : Our cohort included 164 patients, mechanical thrombectomy using stent retriever device had a significant impact on recanalization rate and functional independence at 3 months. In unadjusted analysis mechanical thrombectomy using Solitaire stent retriever showed higher recanalization rate than Penumbra system and chemical thrombolysis (75% vs. 64.2% vs. 49.4%, p=0.03) and higher rate of functional independence at 3 month (53.1% vs. 37.7% vs. 35.4%, p=0.213). In view of the interrelationships between all predictors of variables associated with a good clinical outcome, when the chemical thrombolysis was used as a reference, in multiple logistic regression analysis, the use of Solitaire stent retriever showed higher odds of independent functional outcome [odds ratio (OR) 2.62, 95% confidence interval (CI) 0.96-7.17; p=0.061] in comparison with penumbra system (OR 1.57, 95% CI 0.63-3.90; p=0.331). Conclusion : Our initial data suggest that mechanical thrombectomy using stent retriever is superior to the mechanical thrombectomy using penumbra system and conventional chemical thrombolysis in achieving higher rates of reperfusion and better outcomes. Randomized clinical trials are needed to establish the actual benefit to specific patient populations.

• 대한지리학회지
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• 제50권3호
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• pp.325-338
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• 2015

원격진료는 정보통신기기를 활용해 의료정보를 주고받는 의료 혁신으로 인식되고 있지만, 사실상 오프라인의 여건에 따라 그 적용이 다양하게 나타난다. 예를 들어, 우리나라에서는 원격진료 시행의 기초 단위인 각 시군의 행정권에 따라 같은 의료권에 내에서도 원격진료는 차별적이다. 이에 본 연구에서는 강원도 원격진료 사례를 통해 원격진료의 지역적 차별성의 원인을 알아보았다. 더 나아가 이러한 차별성은 정보격차와 연관성이 있어 원격진료로 인해 유발되는 정보격차의 문제에 대해서도 고찰하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 원격진료의 도입과 더불어 행정 인력의 증원, 실질적인 행정 책임자에 대한 경제적 보상, 원격진료 기기에 대한 교육 등이 제대로 마련되지 않아 이를 수용할 수 있는 지역만이 원격진료를 활용하고 있는 것으로 나타났다. 둘째, 원격진료의 차별적 활용은 지역의료의 최고 결정자라 할 수 있는 시장 혹은 군수, 그리고 보건소장의 관심 여부와 연결된다고 할 수 있다. 셋째, 공중보건의는 원격진료의 실질적인 수행자 역할을 하고 있지만, 원격진료에 실시에 반대하고 있는 의사회와의 관계, 실질적인 지역의료 여건의 개선 미비 등으로 원격진료에 대해 회의적 입장인 것으로 드러났다. 넷째, 원격진료 활용의 지역적 차별성으로 인해 나타나는 정보격차는 아직까지 가시적인 것은 아닐뿐더러, 다른 차원의 격차(의료격차, 지역격차 등)로 전이되지 않았다고 판단되나, 앞으로 원격진료를 기반으로 하는 다양한 서비스가 이루어질 것을 예상한다면 이에 대한 적절한 대책이 필요할 것으로 보인다.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.93-99
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• 2013

Objective : Neurologic complications during carotid artery stenting (CAS) are usually associated with distal embolic event. These embolic incident during CAS are highly associated with the carotid plaque instability. The current study was undertaken to identify the angiographic characteristics of carotid plaque vulnerability, which was represented as filling defect in the cerebral protection filters during CAS. Methods : A total of 107 patients underwent CAS with use of a distal protection filter. Angiographic carotid plaque surface morphology was classified as smooth, irregular, and ulcerated. To determine predictable factors of filling defect in the protection filters, 11 variables were retrospectively analyzed which might influence filling defect in the protection filters during CAS. Results : Filling defects during CAS were presented in the 33 cerebral protection filters. In multivariate analysis, angiographic ulceration [odds ratio (OR), 6.60; 95% confidence interval (CI) : 2.24, 19.4; p=0.001], higher stenosis degree (OR, 1.06; 95% CI : 1.00, 1.12; p=0.039), and coexistent thrombus (OR, 7.58; 95% CI : 1.69, 34.05; p=0.08) were highly associated with filling defect in the cerebral protection devices during CAS. Among several variables, angiographic surface ulceration was the only significant factor associated with flow stagnation during CAS (OR, 4.11; 95% CI : 1.33, 12.72; p=0.014). Conclusion : Plaque surface morphology on carotid angiography can be a highly sensitive marker of plaque instability during CAS. The independent risk factors for filling defect in the filter devices during CAS were plaque ulceration, stenosis degree, and coexistent thrombus.

• The Korean Journal of Pain
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• 제27권4호
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• pp.339-344
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• 2014

Background: The diagnostic criteria of complex regional pain syndrome (CRPS) have mainly focused on dichotomous (yes/no) categorization, which makes it difficult to compare the inter-patient's condition and to evaluate the intra-patient's subtle severity over the course of time. To overcome this limitation, many efforts have been made to create laboratory methods or scoring systems to reflect the severity of CRPS; measurement of the skin temperature asymmetry is one of the former, and the CRPS severity score (CSS) is one of the latter. However, there has been no study on the correlations among the CSS, temperature asymmetry and subjective pain score. The purpose of this study was to evaluate whether there is any correlation between the CSS, skin temperature asymmetry and subjective pain score. Methods: Patients affected with CRPS in a unilateral limb were included in this study. After making a diagnosis of CRPS according to the Budapest criteria, the CSS and skin temperature difference between the affected and unaffected limb (${\Delta}T$) was measured in each patient. Finally, we conducted a correlation analysis among the CSS, ${\Delta}T$ and visual analogue scale (VAS) score of the patients. Results: A total of 42 patients were included in this study. There was no significant correlation between the ${\Delta}T$ and VAS score (Spearman's rho = 0.066, P = 0.677). Also, the CSS and VAS score showed no significant correlation (Spearman's rho = 0.163, P = 0.303). Conclusions: The ${\Delta}T$ and CSS do not seem to reflect the degree of subjective pain in CRPS patients.