• 한국정보전자통신기술학회논문지
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• 제16권5호
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• pp.331-337
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• 2023

본 논문에서는 근감소증의 발병 여부와 정도를 확인하기 위해 3번 요추부 (L3) CT 영상을 검출하는 딥러닝 모델을 제안하는 것이다. 또한, CT 데이터 내에 L3 레벨과 L3 레벨이 아닌 부분의 데이터 불균형으로 인한 성능 저하의 문제점을 오버샘플링 비율과 클래스 가중치를 설계변수로 하는 최적화 기법을 제시하고자 한다. 모델 학습 및 검증을 위하여 강릉아산병원에 내원한 전립선암 환자 104명, 방광암 환자 46명의 총 150명의 전신 CT 영상이 활용되었다. 딥러닝 모델은 ResNet50을 활용하였으며, 최적화기법의 설계변수로는 모델 하이퍼파라미터 5종과 데이터 증강비율 및 클래스 가중치로 선정하였다. 제안하는 최적화 기반의 L3 레벨 추출 모델은 대조군 (하이퍼파라미터 5종만을 최적화한 모델)과 비교하여 중간 L3 오차가 약 1.0 슬라이스 감소한 것을 확인할 수 있었다. 본 연구결과를 통하여 정확한 L3 슬라이스 검출이 가능하며, 추가적으로 데이터 증강을 통한 오버 샘플링과 클래스 가중치 조절을 통해 데이터 불균형 문제를 효과적으로 해결할 수 있는 가능성을 제시할 수 있다.

• Journal of Hospice and Palliative Care
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• 제23권3호
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• pp.103-113
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• 2020

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients' physical and mental symptoms, psychological support, appropriate decision-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

• 한국정보통신학회논문지
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• 제22권8호
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• pp.1107-1113
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• 2018

최근 들어 초음파를 활용한 항암 치료법은 미세한 기포 또는 조영제를 환자에게 주입한 후 특정 주파수의 초음파를 발생시켜 세포의 괴사를 유도하는 치료법으로서, 항암치료 중 발생가능한 부작용을 현저히 감소시킬 수 있는 유용한 치료법으로 제안되고 있다. 이는 정기적인 세포의 사멸은 세포의 손상과 관계없이 필수적인 생물학적 프로세스이며, 초음파는 이러한 세포의 사멸을 유도 또는 증폭시키는 효과가 있기 때문으로 알려져 왔다. 한편, 광 역학 치료는 광원의 고유한 파장에 따라 반응하는 광감응제 등과 같은 화합물을 추가적으로 인체에 주입함으로써 특정 암세포의 괴사 유도가 가능하며 이를 위해 다양한 종류의 레이저 사용이 가능하다. 하지만, 고가의 광원과 대형화된 장비, 광원의 자극으로 인한 발열 현상 등의 한계로 제한적인 사용이 가능하여왔다. 이러한 기술적 한계는 소형 발광 다이오드가 개발됨에 따라 광 역학 치료 장비의 소형화와 발열현상의 제어가 가능하게 되었고, 그 결과 발광 다이오드는 레이저의 대체광원으로 인식되었다. 따라서, 본 논문에서는 의료용으로 광범위하게 사용되며, 부작용이 적고, 비교적 저주파인 1 MHz 초음파 발생장치와 저렴한 발광다이오드를 복합적으로 융합한 일체형 암세포 증식억제 모듈을 개발하고 이를 암세포에 적용시켜 효과를 정량적으로 분석하고자 한다.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2013년도 제44회 동계 정기학술대회 초록집
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• pp.108-109
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• 2013

Mitochondria play key roles in the production of cell's energy. Their dominant function is the synthesis of adenosine 5'-triphosphate (ATP) from adenosine diphosphate (ADP) and phosphate (Pi) through the oxidative phosphorylation. Evaluation of drug-induced mitochondrial toxicity has become increasingly important since mitochondrial dysfunction has recently been implicated in numerous diseases including cancer and diabetes mellitus. Mitochondrial functions have been monitored via oxygen consumption, mitochondrial membrane potential, and more importantly via ATP synthesis since ATP synthesis is the most essential function of mitochondria. Various analytical methods have been employed to investigate ATP synthesis in mitochondria, including high performance liquid chromatography (HPLC), bioluminescence technique, and pH measurement. However, most of these methods are based on destructive analysis or indirect monitoring through the enzymatic reaction. Infrared absorption spectroscopy (IRAS) is one of the useful techniques for real-time, label-free, and direct monitoring of biological reactions [1,2]. However, the strong water absorption requires very short path length in the order of several micrometers. Transmission measurements with thin path length are not suitable for mitochondrial assays because solution handlings necessary for evaluating mitochondrial toxicity, such as rapid mixing of drugs and oxygen supply, are difficult in such a narrow space. On the other hand, IRAS in the multiple internal reflection (MIR) geometry provides an ideal optical configuration to combine solution handling and aqueous-phase measurement. We have recently reportedon a real-time monitoring of drug-induced necrotic and apoptotic cell death using MIR-IRAS [3,4]. Clear discrimination between viable and damaged cells has been demonstrated, showing a promise as a label-free and real-time detection for cell-based assays. In the present study, we have applied our MIR-IRAS system to mitochondria-based assays by monitoring ATP synthesis in isolated mitochondria from rat livers. Mitochondrial ATP synthesis and hydrolysis were in situ monitored with MIR-IRAS, while dissolved oxygen level and solution pH were simultaneously monitored with O2 and pH electrodes, respectively. It is demonstrated that ATP synthesis and hydrolysis can be monitored by the IR spectral changes in phosphate groups in adenine nucleotides and MIR-IRAS is useful for evaluating time-dependent drug effects of mitochondrial toxicants.

• Child Health Nursing Research
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• 제24권4호
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• pp.527-536
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• 2018

Purpose: The purpose of this study was to investigate the needs for pediatric palliative care (PPC) among parents of children with complex chronic conditions (CCCs) and to investigate differences in the needs for PPC according to their general characteristics. Methods: A cross-sectional survey was conducted between March 28 and May 18, 2018. Parents (N=96) who had a child under 18 years with a CCC were recruited. Data were analyzed using descriptive statistics, independent t-test, and one-way ANOVA. Results: The overall average need for PPC was $3.58{\pm}0.33$ out of 4.00. In terms of care for the subjects' children, the highest need was physical care, followed by psychosocial and spiritual care. In the sub-dimensions, preservation of physical function received the highest score. Of the items, the highest need was for seizure control. In terms of care for the subjects themselves, the highest need was for psychosocial care, followed by bereavement and spiritual care. In the sub-dimensions, communication received the highest score. Of the items, the highest need was for smooth communication with medical staff. Differences in needs for PPC according to participants' general characteristics were not statistically significant. Conclusion: Medical staff should provide PPC according to the priorities of parents' perceived needs.

• 임상간호연구
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• 제21권3호
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• pp.319-334
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• 2015

Purpose: The aim of this study was to analyze various nursing services of delivery room nurses by hospital level, and identify importance and frequency to provide baseline data to establish delivery room nurses' roles. Methods: Through DACUM analysis technique, service descriptions, duties, and tasks were derived from the literature. A survey was done of 242 nurses from delivery rooms of hospitals, general hospitals, superior general hospitals, and special hospitals. Importance and frequency of each service were measured using a 4point scale, and results were analyzed using SPSS. Results: Nursing services for delivery room nurses consisted of 18 duties and 86 tasks. Duties with the highest importance were 'labor support' and 'infection management', and those with lowest importance were 'collaborative care' and 'communication'. The duty with the highest frequency was 'labor support', and lowest frequency was 'communication'. There were differences between importance and frequency depending on the size of hospitals. Conclusion: Results of this first study on nursing services of delivery room nurses. delivery room nurses are performing a wide range of nursing services and the various types are clarified including importance and frequency.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.21-27
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• 2008

Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

• Archives of Pharmacal Research
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• 제21권4호
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• pp.398-405
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• 1998

We investigated the effects of triterpene acids (TAs), ursolic acid (UA) and oleanolic acid (OA), on the induction of proliferation and differentiation of normal rat mammary epithelial cells (RMEC) or organoids cultured in Matrigel or primary culture system. To elucidate the effects, we tested their differentiation inducing activities with intercellular communication ability, cell cycle patterns, induction of apoptosis, and morphological differentiation in the three dimensional extracellular culture system. To study the changes of RMEC subpopulation in culture, the cultured cells were isolated, immunostained with peanut lectin (PNA) and anti-Thy-1.1 antibody and then analyzed with flow cytometry. Four different subpopulations, such as PNA and Thy-1.1 negative cells (B-), PNA positive cells (PNA+), Thy-1.1 positive cells (Thy-1.1+), PNA and Thy-1.1 positive cells (B+), were obtained and the size of each subpopulation was changed in culture with time in the presence of TAs. Intercellular communication was observed in culture for 7 days in TAs-treated cells, but not in culture for 4 days with scrape-loading dye transfer technique. $G_2$/M phase cells and the number of apoptotic population were increased in TAs-treated groups in cell cycle analyses. S phase fractions were reduced and the change of $G_1$ phase cells was not observed. The colonies with distinct multicelfular structures, such as stellate, ductal, webbed, squamous, lobulo-ductal colonies, were observed in Matrigel culture and the frequencies of each colony were changed in the presence of TAs. These results suggest that UA and OA have differentiation inducing effects on rat mammary epithelial cells in primary or in Matrigel culture.

• 대한의용생체공학회:의공학회지
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• 제19권4호
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• pp.351-360
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• 1998

아날로그 감마카메라에 비해 디지털 카메라는 Q.C가 편리하고, Calibration과 조작이 매우 쉬운 장점들을 갖고 있어 영상 질을 향상시킬 뿐만 아니라 진단의 정확도를 높일 수 있다. 더욱이, 디지털 카메라로 획득한 디지털 영상은 PACS(Picture Archiving and Communication System) 뿐만 아니라 원격진료에도 활용될 수 있다. 그러나, 많은 병원들이 아직도 아날로그 카메라를 사용하고 있고 이들을 디지털 카메라로 대체하기는 어려운 상황에 있다. 본 연구는 아날로그 감마카메라를 디지털화 할 수 있는지의 가능성을 보는 것이었다. 카메라를 디지털화 한 후 균일도 계수능력 등의 물리적 특성을 측정하였다. 임상에서의 사용 가능성을 보기 위해 아날로그 시스템과 디지털 시스템을 동시에 연결하여 임상 데이터들을 획득하였다. 이들의 결과는 임상환경에서 아날로그 카메라를 디지털화 하 수 있다는 가능성을 보여주었다.

• 한국전자통신학회논문지
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• 제15권6호
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• pp.1217-1222
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• 2020

현재 우리나라를 포함하여 전 세계적으로 환경오염에 관한 연구가 지속으로 진행되고 있으며 그중에서도 다수의 사용자가 이용하는 다양한 시설의 실내 공기를 청정하게 유지, 관리하여 국가적으로 국민의 건강과 환경오염을 예방하기 위해 관련 법령을 시행 등 다양한 노력 들이 이루어지고 있다. 특히 의료기관의 경우 방문하는 다수의 사람이 질환이나 질병을 갖고 있으며 실내 공기 오염과 관련하여 두통, 우울증, 신경과민, 심장병, 암 등의 만성질환에 유의한 영향을 미칠 수 있음이 시사되고 있다. 이러한 상황을 고려하여 본 논문에서는 의료기관에 적용하기 위한 실내 공기 모니터링 IoT 시스템을 통해 공기 오염도에 대한 중앙 모니터링 및 담당자 자동 호출 기능 등을 제공하여 재실자에게 쾌적하고 청정한 실내 환경을 제공할 수 있기를 기대한다.