• 한국방사선학회논문지
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• 제13권7호
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• pp.1015-1024
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• 2019

최근 의료분야에서 X선은 질병의 진단 및 치료영역에서 필수적으로 요구되며, 영상의학 기술의 발전과 더불어 X선의 이용은 지속적으로 증가하는 추세지만, X선은 방사선 피폭의 단점을 가지고 있다. 방사선피폭을 방어하기 위해 임상에서는 납 방호도구를 사용하지만 납은 중금속으로 분류되어 납중독 등 인체에 유해한 반응을 일으킬 수 있다. 따라서 본 연구는 FDM(Fused Deposition Modeling)방식의 3차원 프린터의 재료를 이용하여 제작한 차폐체의 유용성을 알아보고자 한다. 필라멘트의 선감약계수를 확인하기 위해 PLA, XT-CF20, Wood, Glow, Brass를 이용해 팬텀을 제작 하고, CT scan을 하였다. 그리고 100 × 100 × 2 mm 크기의 차폐 시트를 모델링하고, 진단용 X선발생장치와 조사선량계를 이용하여 선량 및 차폐율을 측정하였으며, 납 방호도구와의 차폐율을 비교하였다. 실험결과 Brass의 CT number가 가장 높게 측정되어 Brass를 이용하여 차폐시트를 제작하였으며, 진단용 X선발생장치로 확인한 결과 100 kV, 40 mAs 조건으로 X선 조사 시 6 mm 두께의 차폐시트에서 차폐율이 90 % 이상으로 측정되어 apron 0.25 mmPb보다 차폐율이 높은 것을 확인하였다. 본 연구의 결과 3차원 프린팅 기술로 제작한 차폐체가 진단용 X선 영역에서 높은 차폐율을 보이는 것을 확인하였으며, 납 방호도구와의 비교를 통하여 납을 대체하여 방사선 방호도구로서의 가능성을 알 수 있었다.

• Journal of Chest Surgery
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• 제26권6호
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• pp.475-482
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• 1993

90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

• 사상체질의학회지
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• 제25권3호
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• pp.158-166
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• 2013

Objectives Recently, Sasang Constitutional Analysis Tool (SCAT) was developed using face, body shape, questionnaire, and voice information. The purpose of this paper is to analysis the characteristics of SCAT in detail for the subjects whose Sasang Constitutional (SC) type was confirmed clearly. Methods 1) The SC types of 108 patients were diagnosed by an expert of Sasang constitutional medicine through the observation of improvements after taking more than 20 packs of herbal medicine prescribed 2) The diagnostic results of SCAT were acquired for the patients. 3) Comparison between diagnostic results of the SCAT and expert was performed according to SC probability difference, the number of packs of herbal medicine prescribed, the number of hospital visits, and age. Results 1) The concordance rate was 65.9% and 59.4% in the male and female groups, respectively. 2) Overall, the concordance rate increased as the SC probability difference increased. In case of more than 5% SC probability difference, it increased up to 71.0% and 66.7% in the male and female groups, respectively. 3) The concordance rate did not show any trend as the number of packs of herbal medicine prescribed and the number of hospital visits increased. 4) The higher concordance rate was observed in Taeeumin, Soyangin, and 20s ~ 40s groups of male patients, and in Soyangin, 20s, and 40s groups of female patients. Conclusions The strong and weak points of SCAT were observed and they will contribute to the improvement of SCAT performance.

• 동의생리병리학회지
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• 제24권3호
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• pp.390-400
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• 2010

This study is aimed to test physiological and hematological actions of Rheum palmatum through clinical pilot study optimized for usual oriental medicine prescription. Thirty-one cases were finally collected and the sample extract 100 $m{\ell}$ of Rheum palmatum (ERP) was administered two times in a day during 3 days and checked with blood CBC test, urinalysis, liver function test, abdominal X-ray as well as general diagnostic process of oriental medicine; pattern identification, assessment of shapes and constitution. The total toxic effective rate of ERP was 9.68% in 3 cases of the whole in case of consistent uneasy state in the subjective symptomatic assessment and aggravation of blood and urine examination. The relevant diagnostic factors were so-eum constitution and essence type subject, carapaces species, lung type in the aspect of Jisan shape theory. On the other hand, the positive effective rate of ERP was 29.03% manifesting improvement of vital signs or present illness and no abnormal changes of blood chemistry and urinalysis and simple abdomen radiology. The relevant diagnostic factors were tae-eum constitution, energy type subject, aves species, heart and liver type in Jisan's shape theory. And the other cases were manifesting no specific change through the administration of ERP. The ratio of the numbers of decrease and increase was 44:5 in the tenderness and hardness of abdominal palpation. But if the pattern identification doesn't comply with the aim of rhubarb application despite of constipation and abdominal pain, the tendeness and biochemical report was shown in abnormal change. The mean number of diarrhea by ERP was $16.77{\pm}6.95$ during 3 days after administration, and the frequent areas of abdominal pain were lower>middle>upper in order, and it meant the target site of ERP too. Besides, the toxic reaction against ERP was expressed highly in case of decrease in blood cell count and hemoglobin, hematocrit having blood deficiency syndrome. Likewise, the toxicity of ERP was influenced by pattern identification manifesting present disease condition and diagnostic factors of four constitutions, Jisan's shape theory collaterally. In conclusion, evaluation of herbal toxicity in order for using as a clinical guideline, various diagnostic pattern information and shape features like the above should be studied together with other pharmacologic toxicology test for the future.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4695-4698
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• 2012

Objective: To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors. Materials and methods: In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4. Results: Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively). Conclusions: Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.

• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.153-156
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• 2011

Objective : This prospective, non-randomized study compared the safety and efficacy of the Angio-$Seal^{TM}$ $Evolution^{TM}$ to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography. Methods : From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-$Seal^{TM}$ $Evolution^{TM}$ or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment. Results : Mean time to hemostasis was $0.42{\pm}0.04$ minutes for the angioseal and $15.83{\pm}1.63$ minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications. Conclusion : The Angio-$Seal^{TM}$ $Evolution^{TM}$ is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.

• Advances in pediatric surgery
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• 제19권2호
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• pp.57-65
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• 2013

The entity of negative appendectomies still poses a dilemma in chlidren. Focused computed tomography (CT) scanning has become the diagnostic test of choice in many hospitals. However, the impact of CT scans on the diagnosis in children is unknown exactly. The purpose of this study was to critically evaluate CT scans for the evaluation of acute appendicitis in children, to review utilization of this diagnostic test in our appendicitis population and to determine if diagnostic accuracy has improved. A retrospective analysis of efficacy of CT scan for diagnosis of appendicitis in children was conducted. Children undergoing appendectomy for acute appendicitis were reviewed from 2007 to 2012. Perforation and negative appendectomy (removal of a normal appendix) rates were determined by the final pathologic report. Statistical comparison were made using the $x^2$ test and significance was assigned at p < 0.05. Five hundred four appendectomies were performed. Mean age was $10.1{\pm}3.21$ years, and 62.7% were boys. Overall, 308 children (61.1%) underwent CT scanning, 100 (19.8%) had US performed, and 97 (19.2%) had no radiographic study. A pathologically normal appendix was removed in 8.7% (27 of 308) of CT patients, 9.0% (9 of 100) of US patients, and 11.3% (11 of 97) of patients without a study. The frequency of CT scanning increased from 29.7% (27 of 91) of all children in 2007 to 75.6% (59 of 78) in 2012, whereas utilization of US decreased from 30.8% (28 of 91) to 11.5% (9 of 78). During this time period the difference in the negative appendectomy rate did change significantly from 14% to 6%. Liberal use of CT scans in diagnosing appendicitis in children has resulted in a decreased negative appendectomy rate.

• 전자공학회논문지
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• 제51권6호
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• pp.244-251
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• 2014

본 논문에서, 가스절연개폐장치(GIS)의 정상상태와 비정상상태에 대해 예방진단기술을 이용하여 자세하게 서술하였다. 이 기술은 지능형 GIS 감시시스템에 의해 저장된 GIS의 데이터의 분석과 진단에 근거한다. GIS음의 파형은 방전과 자체내의 코로나 방전음에 의해 발생되는 것으로 잡음과 비슷하다. 그러므로, 본 논문에서, GIS음의 정상 상태와 비정상 상태로 분류하는데, 정상과 비정상 상태를 레벨교차율(LCR)과 스펙트로그램 에너지비율로 이용하여 구분하였다.

• 한국방사선학회논문지
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• 제6권1호
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• pp.11-17
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• 2012

중재적 방사선 시술 시 환자의 피폭선량을 시술별로 분류하여 측정 및 평가하여 안전관리 자료로 활용하고자 하였다. 검사는 시술별(TACE, EVAR, Iliac stent, Lower Limb, BAE, Embolization, PTBD, PTGBD, Abscess, Nephrostomy)로 투시시간, 면적선량, 영상획득이미지 수를 측정하였다. 시술별 분석결과 비혈관계 검사에서 전반적으로 낮은 값을 보였으며, 혈관계 검사에서는 IVC filter를 제외한 모든 검사에서 높은 값을 나타냈다. 투시시간은 EVAR가 24m30s로 가장 높았고, 면적선량 또한 EVAR가 236 $Gy/cm^2$로 가장 높았다. 면적선량률은 TACE가 22.8 $Gy/cm^2$로 높게 나타났다. 이 결과를 토대로 중재적 방사선시술시 환자피폭선량에 대한 기준선량을 제시하고자 한다.

• 멤브레인
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• 제27권2호
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• pp.138-146
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• 2017

새로운 형태의 페녹시-카르복시레이토페녹시기가 함께 치환된 포스파젠 고분자를 여러 치환율을 가지고 합성하였다. 이러한 형태의 포스파젠 고분자를 이용해 당뇨병 진단막을 제조하여 혈액 속의 글루코우즈의 농도를 변화시켜가며 680 nm에서의 흡광도를 측정하였다. 기본적으로 흡광도가 시간에 따라 변화하는 양(K/S)과 글루코우즈의 농도가 직선적인 관계를 가지는 것으로 나타났다. 소수성기인 페녹시기와 친수성기인 카르복시레이토페녹시기의 치환율이 글루코우즈 농도 측정에 미치는 영향을 조사하였다. 친수성기의 치환율이 10% 이하인 경우에는 글루코우즈의 침투속도가 너무 느려 글루코우즈의 농도 측정이 어려웠다. 그러나 친수성기의 치환율이 10% 이상으로 증가함에 따라 글루코우즈의 농도와 K/S의 기울기 값(Dose-Response Slope : DRS)이 점차 증가하였다. 하지만 친수성기의 치환율이 30% 이상일 경우에는 글루코우즈가 너무 빨리 침투하여 DRS가 급격히 증가하였다.