• 혜화의학회지
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• 제9권1호
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• pp.201-214
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• 2000

Precise and detailed clinical research and evaluation based on objective standards are imperative factors in securing reliability of a clinical test. Built on this principle, this clinical test has been conducted during the period between March 1999 and March 2000 dealing with 31 outpatients treated with ShiHo-GuizhiTang or ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions at the Sung-bo ORIENTAL MEDICAL CLINIC. A variety of information relating to those patients has been collected and analyzed under such criteria as precise diagnoses and their clinical effectiveness. The analysis was duly based on "The theory of cold syndrome". Then, the 31 patients' individual clinical information was compared one another by breaking down the results into sub-categories including gender, age, disease, main symptom, blood pressure, pulse beats, syndrome of abdomen, treatment period, modify and mixed prescription, and evaluation. The result of this clinical test can be summarized as follows: First, ShiHo-GuizhiTang appears to be more frequently prescribed in the case of female patients than in the case of male patients despite the fact that it does not necessarily need to be applied only to female. In addition, the numbers of prescriptions of ShiHo-GuizhiTang in the two age groups consisting of elementary school children and economically active adults respectively were the highest among other age groups. Second, ShiHo-GuizhiTang proved to be most effective in treatment for respiratory ailments and arthritis. Third, ShiHo-GuizhiTang brought down blood pressure of hypertension patients and at the same time benefited patients with normal or lower-than-normal blood pressure who were vulnerable to diseases due to low disease-resistance. Fourth, ShiHo-GuizhiTang was effective in the case of frequent pulse(rapid pulse) and thereby indicating the fact it carries Taiyang superficies syndrome. 지맥 arises from suppressed immune responses owing to adrenocortical hormones. ShiHo-GuizhiTang controls and revitalizes those suppressed immune systems which stem from slow pulse and, as a consequence of that process, helps them return to normal condition of pulse. Fifth, from the standpoint of syndrome of abdomen, feeling of obstruction in the epigastrium serves as an important standard in the process of diagnosing diseases and evaluating effectiveness of treatments. Sixth, according to the results of the clinical test with the 31 patients, a total of 81 percent of test subjects benefited from the treatment. The figure is the sum of 52 percent of I-class (both main symptom and accompanying symptoms had been eliminated) and 29 percent of II-class (part of main symptom and accompanying symptoms had been eliminated) respectively. All told it is safe to say that ShiHo-GuizhiTang can elect to be a viable clinical treatment. In conclusion, it is estimated that this clinical study has drawn up guidelines for objective diagnostic standards and evaluation on specific treatments' effectiveness. This will lead to more general application of ShiHo-GuizhiTang. On top of that, this study could also provide an opportunity to stress the significance of ShiHo-GuizhiTang and ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions as an alternative treatment for collagen disease which comes from environmental degradation and pollution.

• Investigative Magnetic Resonance Imaging
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• 제19권4호
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• pp.231-236
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• 2015

A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.

• 임상간호연구
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• 제19권3호
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.74-79
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• 2010

Background: Legionella pneumophila has been recognized as an important cause of pneumonia. However, limited data are available in the literature regarding legionella pneumonia in Korea. The objective of this study was to compare epidemiological data and clinical presentation of legionella pneumonia and pneumococcal pneumonia. Methods: We retrospectively compared clinical, radiological, and laboratory data, antimicrobial treatment, and treatment outcomes between 28 cases of legionella pneumonia and 56 cases of pneumococcal pneumonia. Diagnoses of both legionella and pneumococcal pneumonia were based on commercial urinary antigen tests. Results: Legionella pneumonia patients included 23 men and 5 women, with a mean age of 61.6 years (range 36~88). Fifteen were smokers and 26 had some underlying diseases. Legionella pneumonia occurred more frequently in healthcare-associated settings than pneumococcal pneumonia (42.9% vs 21.4%, respectively, p=0.040). There were no significant differences in clinical signs and symptoms. Compared to patients with pneumococcal pneumonia, patients with legionella pneumonia presented more frequently with anemia (39.3% vs 8.9%, p=0.001), increased C-reactive protein (57.1% vs 30.4%, p=0.018) and increased alkaline phosphatase (46.4% vs 16.1%, p=0.003). Also, legionella pneumonia patients more often showed pleural effusion on simple chest X-rays (50.0% vs 12.5%, p<0.001). Conclusion: Legionella pneumonia and pneumococcal pneumonia can not be distinguished by clinical manifestations alone. However, legionella pneumonia occurred as a healthcare-associated pneumonia more frequently and was more often associated with anemia and increased CRP and alkaline phosphatase levels.

• 대한의용생체공학회:의공학회지
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• 제19권5호
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• pp.469-476
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• 1998

초음파, 내시경 등의 NTSC 영상을 PC를 통해 획득하고, 고해상도의 YGA 모니터에 표시할 경우 주사변환 과정을 거치면서 치명적인 영상의 왜곡(tear-drop)이 나타난다. 본 연구에서는 이러한 왜곡을 해소하는 여러 가찌 방법을 살펴보고 실시간으로 왜곡을 보정할 수 있는 하드웨어를 PC상에서 구현하였다. 하드웨어 시스템은 De-Interlace 전용의 소자와 PCI bridge 등을 이용함으로써 고화질의 영상표현과 실시간의 영상전송이 가능하다 구현된 시스템에서 영상의 질은 눈에 띄게 향상되었으며, PC 기반의 시스템으로 구성함으로써 영상의 저장, 전송 및 텍스트의 기록 등 다양한 기능을 쉽게 구현할 수 있었다.

• 지능정보연구
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• 제13권1호
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• pp.15-27
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• 2007

간암은 우리나라에서 전체 암 사망자 중 17.2%로 3번째의 흔한 사망 원인이며, 간암에 의한 사망률은 인구 10만 명당 약 21명에 이른다. 본 논문에서는 간 내부에서 발생하는 간 세포암을 CT 영상에서 자동으로 추출하는 방법을 제안하여 간 세포암의 보조진단으로서의 유용성에 대해 알아보고자 한다. 간 내부의 종양을 추출하기 위해 흉부의 윗부분에서 시작하여 2.5mm의 간격으로 약 $45{\sim}50$장 정도를 촬영한 CT 영상들을 대상으로 간 영역을 추출한다. 간 영역 추출은 관심이 없는 외부 영역을 갈비뼈를 중심으로 제거한 후, 영상의 자기 정보를 이용하여 각 기관의 영역을 분할한다. 분할된 영역들은 위 아래로 인접한 영상에서의 분할 영역들과 자기 값을 비교하여 적절하게 병합하는 3차원적 접근방법을 적용한다. 간 영역은 여러 개의 영역들 중에서 간 영역의 구조 및 위치 등의 정보를 활용하여 추출한다. 추출된 간 영역에서 종양 판별과 추출을 위해 종양이 가지는 특징을 분석하여 종양을 추출한다. 전형적인 간 세포암은 과혈관성 종양이므로 조영증강 CT 영상에서는 주위보다 밝은 색으로 나타나며, 팽창형 성장을 보일 경우에는 구형으로 나타나는 특징이 있다. 이에, 주위 보다 밝은 색을 가지고 둥근 형태를 가지는 영역을 종양의 후보 영역으로 선정한 후, 그 영상의 위와 아래로 연결되는 영상에서도 같은 위치에서 같은 특징을 보이는 영역이 있으면 간 내부의 종양으로 판별하여 추출한다. 제안된 간 영역 및 간 종양 추출 방법의 정확성을 판별하기 위하여 CT 영상을 대상으로 실험하여 영상의학 전문의가 판단한 결과와 비교하였다. 간 영역 추출은 정확히 모두 추출되었으며, 간 종양 추출 및 판별은 전문의의 보조 진단 도구로 활용할 수 있는 가능성이 매우 높다는 것을 확인할 수 있었다.

• Clinics in Shoulder and Elbow
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• 제10권2호
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• pp.190-198
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• 2007

목적: 주관절 골절이나 탈구로 인해 일차적으로 수술적 치료를 받은 후 불량한 임상적, 방사선학적 결과를 보이는 환자를 대상으로 반구속형 인공 주관절 전 치환술을 시행하여 그 임상적 결과 및 효용성을 알아 보고자 하였다. 대상 및 방법: 1995년 1월부터 2005년 12월까지 주관절 부위 골절 혹은 탈구로 수술적 치료를 시행한 환자 중 반구속형 인공 주관절 전 치환술을 시행한 12예를 대상으로 하였다. 처음 수상시 진단은 상완골 원위부 골절이 8예, 주관절부 골절 및 탈구가 4예였다. 첫 수술 후 평균 12개월 후에 반구속형 인공 주관절 전 치환술을 시행하였고 추시 기간은 평균 43개월 이었다. 결과: 술후 환자의 평균 능동적 관절 운동 범위는 술전과 비교하여 신전은 14.2도에서 5.4도로, 굴곡은 96.7도에서 122.1도로, 회외전은 50.8도에서 63.3도로, 회내전은 53.3도에서 67.5도로 향상되었다(p<0.05). 환자 중 3예에서는 상완골에서 방사선학적 투과선이 관찰되었으며 각각 제 3형 1예, 제 4형 2예가 있었다. 이들은 모두 재치환술을 시행하였다. 술후 Mayo 주관절 기능 평가 점수는 평균 79점이었다. 최우수는 6예, 우수 2예, 불량 4예였다. 결론: 주관절부 골절 및 탈구로 인한 손상에 대해 일차적인 수술적 치료 후 실패한 경우에 인공 주관절 전 치환술을 시도하여 양호한 임상 결과를 얻을 수 있었다.

• 대한세포병리학회지
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• 제18권2호
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• pp.119-125
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• 2007

Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as $ThinPrep^{(R)}$, have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the $ThinPrep^{(R)}$ preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The $ThinPrep^{(R)}$ method showed 53.1% sensitivity, 92.6% specificity, a 92,6% positive predictive value, a 94.1% negative predictive value and 85,6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88,6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the $ThinPrep^{(R)}$ method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.

• 한국가축번식학회지
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• 제20권3호
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• pp.323-331
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• 1996

포유동물에 있어서 조기 성 판정기술은 축산에 있어서의 성별 육종프로그램이나 인간의 X-염색체 관련 열성유전병의 산전진단 등 여러 분야에 응용될 수 있다. 초기배에 대한 성 판정은 성염색체에 존재하는 특이한 염기서열을 증폭시키는 polymerase chain reaction (PCR)과 X와 Y 염색체에 대한 특이적 probe를 이용하는 fluorescent in situ hybridization (FISH)에 의하여 수행될 수 있다. 1992년과 93년, 2개년도에 걸쳐 본 연구실에서 돼지의 3.3 kb 웅성특이 DNA 절편(pEM39)을 cloning하였다. 본 연구는 pEM39가 성특이 DNA-probe로 이용될 수 있는지를 조사하기 위해 PCR과 FISH를 이용하였다. 돼지 난자는 도축장에서 구입한 돼지 난소로부터 채취되었고, 체외배양후 체외수정되었다. 한편 처녀발생나자를 negative control로 이용하였다. 2 세포기의 수정란을 선발한 후 PCR을 통하여 DNA를 분석한 결과, 10개의 수정란 중 6개는 자성, 다른 4개는 웅성으로 판정되었으며, FISH를 수행한 결과, done된 웅성특이 DNA 단편은 돼지 간조직과 초기배에서 웅성특이성을 보였다. 또한 FISH와 karyotyping을 수행한 결과 clone된 웅성특이 DNA 단편이 Y 염색체 q-arm의 heterochromatic region에 위치함을 알 수 있었다. 이러한 결과로 보아 clone된 웅성특이 DNA 단편이 초기배의 성을 조기판정하는데 있어 유용하리라 사료되며, PCR에 의한 초기배의 성 판정에 있어 신뢰할만할 지표가 될 수 있을 것이다.

• 기록학연구
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• 제65호
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• pp.151-197
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• 2020

기록관리 평가제도는 『공공기록물 관리에 관한 법률』에 근거해 2007년 이래 국가기록원이 운영하는 제도이다. 공공기록관리 환경이 극심하게 변화하면서 이 평가제도의 방식에도 근본적인 제고가 필요하다는 인식이 확산되고 있다. 특히, 가장 역점을 두어야 할 부분으로 기관의 유형과 특성에 따른 맞춤형 방식이 요구되고 있다. 이 연구는 새로운 공공기관 기록관리 평가제도로서 기관의 자율적인 평가 역량을 강화하는 것을 기본 취지로 하는 자체평가 방식에 주목하였다. 자체평가 방식으로 변화해야 할 필요성을 평가대상 기관의 다양성, 기록관 조직 형태의 특수성, 기관 위계 등과 관련하여 설명하고, 기관 스스로 기록관리업무를 진단하고 업무수행 수준의 향상을 지향하는 체계로서 자체평가제도(안)을 설계하였다. 아울러 공공기관 기록관리 평가제도를 공공기록관리 실무에서 단계적으로 작동시키기 위한 평가항목 및 지표 개발과 단계적 적용, 법적, 운영적 측면들을 다루었다.