• 제목/요약/키워드: standard hospital

검색결과 2,890건 처리시간 0.028초

Nonlinear Conte-Zbilut-Federici (CZF) Method of Computing LF/HF Ratio: A More Reliable Index of Changes in Heart Rate Variability

  • Vernon Bond, Jr;Curry, Bryan H;Kumar, Krishna;Pemminati, Sudhakar;Gorantla, Vasavi R;Kadur, Kishan;Millis, Richard M
    • 대한약침학회지
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    • 제19권3호
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    • pp.207-212
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    • 2016
  • Objectives: Acupuncture treatments are safe and effective for a wide variety of diseases involving autonomic dysregulation. Heart rate variability (HRV) is a noninvasive method for assessing sympathovagal balance. The low frequency/high frequency (LF/HF) spectral power ratio is an index of sympathovagal influence on heart rate and of cardiovascular health. This study tests the hypothesis that from rest to 30% to 50% of peak oxygen consumption, the nonlinear Conte-Zbilut-Federici (CZF) method of computing the LF/HF ratio is a more reliable index of changes in the HRV than linear methods are. Methods: The subjects of this study were 10 healthy young adults. Electrocardiogram RR intervals were measured during 6-minute periods of rest and aerobic exercise on a cycle ergometer at 30% and 50% of peak oxygen consumption ($VO_{2peak}$). Results: The frequency domain CZF computations of the LF/HF ratio and the time domain computations of the standard deviation of normal-to-normal intervals (SDNN) decreased sequentially from rest to 30% $VO_{2peak}$ (P < 0.001) to 50% $VO_{2peak}$ (P < 0.05). The SDNN and the CZF computations of the LF/HF ratio were positively correlated (Pearson's r = 0.75, P < 0.001). fast Fourier transform (FFT), autoregressive (AR) and Lomb periodogram computations of the LF/HF ratio increased only from rest to 50% $VO_{2peak}$. Conclusion: Computations of the LF/HF ratio by using the nonlinear CZF method appear to be more sensitive to changes in physical activity than computations of the LF/HF ratio by using linear methods. Future studies should determine whether the CZF computation of the LF/HF ratio improves evaluations of pharmacopuncture and other treatment modalities.

Diagnostic Evaluation of Non-Interpretable Results Associated with rpoB Gene in Genotype MTBDRplus Ver 2.0

  • Singh, Binit Kumar;Sharma, Rohini;Kodan, Parul;Soneja, Manish;Jorwal, Pankaj;Nischal, Neeraj;Biswas, Ashutosh;Sarin, Sanjay;Ramachandran, Ranjani;Wig, Naveet
    • Tuberculosis and Respiratory Diseases
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    • 제83권4호
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    • pp.289-294
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    • 2020
  • Background: Line probe assay (LPA) is standard diagnostic tool to detect multidrug resistant tuberculosis. Non-interpretable (NI) results in LPA (complete missing or light wild-type 3 and 8 bands with no mutation band in rpoB gene region) poses a diagnostic challenge. Methods: Sputum samples obtained between October 2016 and July 2017 at the Intermediate Reference Laboratory, All India Institute of Medical Sciences Hospital, New Delhi, India were screened. Smear-positive and smear-negative culture-positive specimens were subjected to LPA Genotype MTBDRplus Ver 2.0. Smear-negative with culture-negative and culture contamination were excluded. LPA NI samples were subjected to phenotypic drug susceptibility testing (pDST) using MGIT-960 and sequencing. Results: A total of 1,614 sputum specimens were screened and 1,340 were included for the study (smear-positive [n=1,188] and smear-negative culture-positive [n=152]). LPA demonstrated 1,306 (97.5%) valid results with TUB (Mycobacterium tuberculosis) band, 24 (1.8%) NI, three (0.2%) valid results without TUB band, and seven (0.5%) invalid results. Among the NI results, 22 isolates (91.7%) were found to be rifampicin (RIF) resistant and two (8.3%) were RIF sensitive in the pDST. Sequencing revealed that rpoB mutations were noted in all 22 cases with RIF resistance, whereas the remaining two cases had wild-type strains. Of the 22 cases with rpoB mutations, the most frequent mutation was S531W (n=10, 45.5%), followed by S531F (n=6, 27.2%), L530P (n=2, 9.1%), A532V (n=2, 9.1%), and L533P (n=2, 9.1%). Conclusion: The present study showed that the results of the Genotype MTBDRplus assay were NI in a small proportion of isolates. pDST and rpoB sequencing were useful in elucidating the cause and clinical meaning of the NI results.

자동차 정비업체 도장공정의 작업환경 및 근로자 노출 실태에 관한 연구 (A Study of Working Environment for Automotive Painting in Auto Repair Shops and Workers' Exposure to Hazardous Chemicals)

  • 심상효;정춘화;임진숙;이형구;김윤신
    • 한국환경보건학회지
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    • 제35권3호
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    • pp.153-161
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    • 2009
  • The purpose of this paper is to evaluate 1) blood lead levels of workers at auto repair shops as Biological Exposure Indices (BEI) of toxic substances such as lead and toluene that are produced during automotive painting process, 2) the differences depending on personal characteristics of workers who have been exposed to toluene by using urine hippuric acid concentration as a marker and 3) the correlation between the concentration of hazardous chemicals in each workplace and the BEL. All subjects were male with a mean age of 36.2 years. In terms of age, most were in the 30 to 40 age group (13 persons, 48.1%). In relation to the length of work experience, the highest proportion had experience of 10 years of less (18 persons, 66.7%). Twenty three workers were cigarette smokers (85.2%) while 4 (14.8%) were non-smokers. In addition, more than 80% of the workers drank alcohol. Dust concentration and toluene exposure during automotive painting showed no significant difference with age, length of work experience, smoking and drinking while a significant difference (p<0.05) has been detected between lead concentration and smoking. The geometric mean of dust concentration, lead concentration and toluene concentration were $0.38mg/m^3,\;0.0021mg/m^3$ and 1.08ppm respectively. In addition, the geometric mean of blood lead levels and urine hippuric acid concentration were $1.70{\mu}g/dl$ and 0.25g/g respectively, which were lower than the standard levels suggested by the Ministry of Labor. To determine the influential factors on blood lead and urine hippuric acid concentrations, a correlation analysis has been conducted with variables of air, lead and toluene concentrations, age, length of work experience and amount of cigarette smoking. According to the analysis, a relatively high correlation (p<0.01) has been observed between air lead concentration and biological sample concentration.

위암환자에서 위절제술 시 근위부 절제연거리의 임상적 중요성 (Clinical Importance of the Resection Margin Distance in Gastric Cancer Patients)

  • 하태경;권성준
    • Journal of Gastric Cancer
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    • 제6권4호
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    • pp.277-283
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    • 2006
  • 목적: 위암환자에서 위절제술 시행 시 절제연거리가 종양의 특성에 따라 재발률, 재발양상 및 예후에 어떠한 영향을 미치는지 명확히 알려져 있지 않다. 연구자들은 이런 관점에서 분석하여 보다 적극적인 치료가 필요한 대상환자를 선별하여 맞춤치료의 기준을 찾고자 한다. 대상 및 방법: 본원에서 1992년 6월부터 2005년 12월까지 위암으로 위절제술을 시행 받은 환자 중 절제연 암침윤 음성이었던 4,472명을 대상으로 후향적 연구를 시행하였다. 추적기간 중앙값은 37개월($1{\sim}162$개월)이었다. 결과: 조기위암 환자군에서 절제연거리가 2 cm 미만인 군과 이상인 군 사이에 재발률, 재발양상 및 5년 생존율에 차이가 없었다. 진행위암 환자는 절제연거리 3 cm를 기준으로 분류하였을 때 그 이상인 경우와 미만인 환자군의 생존율에 의미있는 차이가 있었다(P=0.02). 진행위암 환자 중 미만형, 위하부 1/3 위암, Borrmann 3, 4형은 절제연거리가 3 cm 이상인 군이 미만인 군에 비해 생존율의 의미 있는 차이를 보였다(P<0.05). 생존율에 영향을 미치는 인자는 다변량 생존분석 결과 연령, 병기, 수술방법, Borrmann형, 근치도가 독립적인 인자였다. 결론: 위암환자에서 위절제술 시행 시 종양의 변연부와 근위부 위절제연까지의 거리는 조기위암의 경우 재발률 및 생존율에 영향을 미치는 의미 있는 인자로 생각되지 않으며, 진행위암은 미만형, 하부 1/3, Borrmann 3, 4형의 경우에는 절제연을 3 cm 이상 확보하는 것이 환자의 생존율 향상에 중요할 것으로 판단된다.

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중풍(中風)환자의 습담(濕痰)변증과 혈중지질의 상관성에 관한 Case-Control 연구 (Case-Control Study on Relationship of Dampness-phlegm to Blood Lipid Level in Stroke Patients)

  • 김민지;강병갑;안정조;조현경;유호룡;김윤식;설인찬
    • 동의생리병리학회지
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    • 제23권6호
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    • pp.1470-1479
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    • 2009
  • The purpose of this study was to investigate the relationship of Dampness-phlegm to blood lipid level and second reason of hyperlipidemia in acute stroke patients by case-control study. This study was done over 348 patients hospitalized in the Oriental Medical Hospital of Daejeon University of November 2006 to July 2008. Patients had been interviewed by residents and medical specialists who studied standard operation procedures in Fundamental Study for Syndrome of Oriental Medicine for Stroke. Study subjects consisted of 86 patients who distributed to Dampness-phlegm by medical specialist and discriminating program as the case I group, 157 patients who distributed to Dampness-phlegm by medical specialist or discriminating program as the case II group and 191 patients who distributed to Non-Dampness-phlegm by medical specialist and discriminating program as the control group. For the purpose of obtaining suitable result we analyzed blood lipid level of each group by univariate and multivariate logistic analysis. Dampness-phlegm was not significant correlated with increasing of Total cholesterol, Triglyceride and decreasing of HDL cholesterol. Dampness-phlegm was significant correlated with increasing LDL cholesterol and the independent predictors of hyperlipoproteinemia by multivariate logistic analysis. Dampness-phlegm was not significant correlated with diabetes melitus, liver disease, kidney disease, obesity and abdominal obesity. In this study, we demonstrated new relationship between Dampness-phlegm and LDL cholesterol. Based on these results, it is suggested that Dampness-phlegm would be the independent predictors of hyperlipoproteinemia. And more prospective studies are to be done with more clinical data.

스트립을 이용한 요분석시스템의 개발과 퍼지추론에 의한 검사결과 평가에 관한 연구 (A Study on the Development of Urine Analysis System using Strip and Evaluation of Experimental Result by means of Fuzzy Inference)

  • 전계록;이승진;최병철;안시훈;하광;김주열;김재형
    • 대한의용생체공학회:의공학회지
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    • 제19권5호
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    • pp.477-486
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    • 1998
  • 본 연구에서는 요분석용 스트립을 이용하여 요의 상태를 정량적·정성적으로 측정할 수 있는 요분석시스템을 구현하였다. 요분석시스템의 분석 알고리듬은 온도 변화, 전원 노이즈 통의 외란에 강인한 특성을 나타내기 위하여 퍼지 논리를 적용하였다. 강인하고 안정적인 요분석시스템을 설계하기 위하여 스트립 9가지 패드의 분강학적 특성을 검토하였다. 요분석시스템 하트웨어와 소프트웨어로 구성되었다. 요분석시스템의 하드웨어는 단일칩 마이크로프로세서를 사용하였고, 주변장치들로는 광하부, 트레이 제어, 전치증폭부, PC와의 통신, 열전사 프린터 및 동작 상태 표시기로 구성하였다. 요분석시스템의 소프트웨어는 시스템 프로그램과 분류 프로그램으로 구성하였다. 시스템 프로그램은 시스템 제어와 데이터 취득 및 분석을 수행하도록 하였다. 분규 프로그램은 퍼지추론부와 멤버쉽함수 발생기로 구성되었다 멤버쉽함수 발생기는 정도관리의 통계학적 방법을 이용하여 삼각형 멤버쉽함수를 생성하였다. 측정된 데이터는 PC로 전송되고, 전송된 데이터는 C++로 작성된 데이터 관리 및 취득 프로그램에 의해 저장된다. 요분석시스템의 정확도와 퍼지분류기의 안정성은 표준시료를 이용하여 평가하였다. 실험결과는 검사항목과 만족한 일치를 보였다.

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타박(打撲)에 의한 활액낭종(滑液囊腫)의 치험례(治驗例) (Treatment Example of Bursitis Caused by Stroke)

  • 이수경;이용양;김영환;박원환
    • 대한한의진단학회지
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    • 제14권1호
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    • pp.79-95
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    • 2010
  • Background and Purpose : By preventing diseases caused by exogenous evil, disorder of internal organs, and seven modes of emotions and adapting to mother nature when the mind is unsettled, and keeping the body and mind relaxed diseases can be avoided, but there can be unpredicted situations caused accidentally by stroke. Currently the general prescription is regulating the flow of vital energy including drugs eliminating blood stasis. Even though the stroke is resulted from diseases caused by exogenous evil, by observing the patient's physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart to clear the upper body and invigorate the functions of the spleen and stomach and purge with drugs of warm nature is a closer approach than simply prescribing vital energy regulating drugs with eliminating blood stasis to the main purpose of treatment. Methods : 1) The subject of the study are 2 cases of patients who have visited the private hospital of the person who is announcing the results of the study. These patients have been given a diagnosis of edema or cystoma caused by bursitis in the knee joint through perception or medical examination and were waiting for operational application. 2) Sources related to stroke from Dong Eui Bo Gwam(東醫寶鑑) were used as the general standard of Korean Traditional Medicine, and to promote the understanding the original text and the translation has been given. 3) By observing the whole body such as the patient's usual physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart, or partly using the "Yin is even and well while Yang is firm" theory of "Plain Questions" as the background to present the results of the clinical study. Results and Conclusion : Generally the prescriptions from the first volume of Dong Eui Bo Gwam(東醫寶鑑) are mostly drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating blood circulation. Also prescriptions for bone fracture or fracture of bones and sinews are mostly to eradicate blood stasis with drastic drugs or coaptation drugs added to drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating vital energy, possessing warm properties for the Xue system.

레진 인레이 합착시 지각과민처리제의 사용이 상아질 결합강도에 미치는 영향 (EFFECT OF A DESENSITIZER ON DENTINAL BOND STRENGTH IN CEMENTATION OF COMPOSITE RESIN INLAY)

  • 한세희;조영곤
    • Restorative Dentistry and Endodontics
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    • 제34권3호
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    • pp.223-231
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    • 2009
  • 본 연구는 인레이 와동에서 인상을 채득하기 전 지각과민처리제 (Isodan)과 2단계 전부식 접착시스템 (One-Step)과 단일단계 자가부식 접착시스템 (All-Bond SE)으로 처리한 후, 복합레진 인레이를 자가 접착형 레진시멘트인 BisCem으로 합착시키는 경우 레진 인레이의 상아질에 대한 미세인장결합강도와 주사현미경적인 분석을 통하여 비교하였다. 본 연구의 결과, 지각과민처리제인 Isodan만을 사용하는 경우 레진 인레이의 결합강도를 감소시킬 수 있으므로 단독 사용보다는 단일 단계 자가부식 시스템 (All-Bond SE)과 같이 사용하는 것이 추천된다.

맘모그래피의 화질과 평균유선조직선량에 관한 검토 (A Study on the Image Quality of Mammography and the Average Glandular Dose)

  • 이인자;김학성;김성수;허준
    • 대한방사선기술학회지:방사선기술과학
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    • 제25권2호
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    • pp.47-55
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    • 2002
  • 유방촬영에 대한 화질과 평균유선조직선량에 대하여 실험한 결과 반가층은 장치마다 큰 차이를 나타내지 않았으며, 자동노출기구를 사용할 경우 정확성에 문제가 있으므로 확인이 필요하다. 유방촬영에 사용되는 자동현상기 또한 꼭 관리가 필요하며, 유방촬영 시 사용되는 증감지/필름에 따라서 팬톰 촬영 식별능에 많은 영향을 받고 있으므로 선택 시 신중을 기해야 한다. 유방두께 4.2 cm에 대한 평균유선조직 선량은 관전압에 따라 달라지며, ACR기준인 3.0 mGy보다 훨씬 적은 $0.26{\sim}1.39\;mGy$로 나타났다. 이상에서 알 수 있듯이 유방촬영에서는 촬영장치의 성능뿐만 아니라 HVL, AEC, 자동현상기 관리, 증감지/필름 등 모두 관리가 되어야 하며, 이로 인해 평균유선조직선량은 더 줄일 수 있을 것이다.

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몬테카를로 시뮬레이션에서의 다양한 환경 샘플에 대한 Marinelli 비이커 측정 및 자기 흡수 보정과 적용 (Marinelli Beaker Measurement and Self Absorption Correction and Application for Various Environmental Samples in Monte Carlo Simulation)

  • 장은성;김양수;이선영
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권4호
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    • pp.605-611
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    • 2017
  • 검출기의 구조를 PENELOPE의 코드를 사용하여 전산모사 하였다. 표준혼합시료(450, 1,000 ml)를 사용하여 다양한 밀도와 높이에 따른 저에너지(59.54 keV)부터 고 에너지(1,836.05)에 대한 측정효율과 PENELOPE 전산모사에서 구한 효율을 비교하였으며, 또한 자체흡수에 대한 효율을 보정하여 다양한 환경시료에 적용하여 검출하한치를 알아보고자 한다. 표준혼합선원의 전체에너지 피크효율 값을 적용하여 높이에 따른 효율변화를 측정치와 PENELOPE의 전산모사 값과 비교하였다. 여기서 구한 값들을 자체흡수 보정하여 구한 효율을 실제 환경시료에 적용하여 검출하한치 값들을 구하였다. 밀도보정인자는 밀도가 $0.4g/cm^3$에서 241Am(59.54 keV)의 밀도보정인자는 1.15, PENELOPE 전산모사에서는 1.153, 137CS(661.66 keV) 에서는 $1.06g/cm^3$, PENELOPE 전산모사에서는 1.064, 88Y(1,836.04 keV)에 대한 밀도보정인자는 1.03, PENELOPE 전산모사에서는 1.033으로 불확도는 1% 이내에서 잘 일치함을 확인하였다. 환경 시료의 밀도에 따른 방사능 농도는 시료량이 많을수록, 측정시간이 증가할수록 MDA(Minimum Detectable Activity) 값이 감소함을 확인할 수 있었다.