• KSII Transactions on Internet and Information Systems (TIIS)
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• 제14권6호
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• pp.2480-2496
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• 2020

Considering that high-dose X-ray radiation during CT scans may bring potential risks to patients, in the medical imaging industry there has been increasing emphasis on low-dose CT. Due to complex statistical characteristics of noise found in low-dose CT images, many traditional methods are difficult to preserve structural details effectively while suppressing noise and artifacts. Inspired by the deep learning techniques, we propose a densely connected residual network (DCRN) for low-dose CT image noise cancelation, which combines the ideas of dense connection with residual learning. On one hand, dense connection maximizes information flow between layers in the network, which is beneficial to maintain structural details when denoising images. On the other hand, residual learning paired with batch normalization would allow for decreased training speed and better noise reduction performance in images. The experiments are performed on the 100 CT images selected from a public medical dataset-TCIA(The Cancer Imaging Archive). Compared with the other three competitive denoising algorithms, both subjective visual effect and objective evaluation indexes which include PSNR, RMSE, MAE and SSIM show that the proposed network can improve LDCT images quality more effectively while maintaining a low computational cost. In the objective evaluation indexes, the highest PSNR 33.67, RMSE 5.659, MAE 1.965 and SSIM 0.9434 are achieved by the proposed method. Especially for RMSE, compare with the best performing algorithm in the comparison algorithms, the proposed network increases it by 7 percentage points.

• 한국방사선학회논문지
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• 제14권6호
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• pp.833-839
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• 2020

전 세계적으로 중증 급성 호흡 증후군 코로나바이러스에 의해 감염예방 및 사회적 인식이 크게 변화되었으며, 그로 인해 의료 원내감염 노출이 높은 환자에 관한 감염관리 지침 및 과정을 더 강화하고 관리감시를 더 철저히 하고 있다. 감염예방을 위해서는 멸균이 최우선으로 시행이 되어야 하며, 저비용, 쉬운 설치와 조작이 쉬운 멸균법을 찾아 적절한 멸균효과를 제시하고자 한다. 본 연구에서는 충치균을 오염시켜 출력 4 W, 조사 시간 60, 150, 300 sec로 자외선 살균기를 이용하였으며, 레이저는 출력 0.8, 1.5 W로 각각 파장 266, 355 nm로 조사하였다. 자외선 살균기는 150 sec 이상에서 감염예방에 안전성을 나타내었으며, 레이저는 1.5 W와 0.8 W, 266 nm에서 예방의 안전성을 나타내었다. 결과에서 출력이 높고 253.7 nm에 가까운 파장일수록 멸균효과는 뛰어났다.

• Genomics & Informatics
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• 제6권1호
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• pp.36-43
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• 2008

Radiotherapy would be the choice of treatment for human cancers, because of high cost-effectiveness. However, a certain population of patients shows a resistance to radiotherapy and recurrence. In an effort to increase the efficacy of radiotherapy, many efforts were driven to find the genes causing the unresponsiveness to ionizing radiation. In this paper, we compared the gene expression profiles of two lung cancer cell lines, H460 and H1299, which showed differential responses to ionizing radiations. Each cell were irradiated at 2 Gy, and harvested after 0, 2, 4, 8, 12 and 24 hours to examine the expressions. Two-way ANOVA analysis on time-series experiments of two cells could select 2863 genes differentially expressed upon ionizing radiation among 32,321 genes in microarray (p<0.05). We classified these genes into 21 clusters by SOM clustering according to the interaction between cell types and time. Two SOM clusters were enriched with apoptosis-related genes in pathway analysis. One cluster contained higher levels of phosphatidyl inositol 3-phosphate kinase (PI3K) subunits in H1299, radio-resistant cells than H460, radiosensitive cells. TRAIL receptors were expressed in H460 cells while the decoy receptor for TRAIL was expressed in H1299 cells. From these results, we could characterize the differential responsiveness to ionizing radiation according to their differential expressions of apoptosis-related genes, which might be the candidates to increase the power of radiotherapy.

• 한국산학기술학회논문지
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• 제17권4호
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• pp.340-350
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• 2016

의료법에서는 의원은 외래환자를, 상급종합병원은 중증의 입원환자를 전문적으로 치료하는 의료기관으로 규정하고 있다. 그러나 일차의료를 제공하는 의원의 외래환자수는 위축되는 반면 상급종합병원의 외래진료비 비중은 지속적으로 증가하고 있다. 이 연구에서는 우리나라 의료전달체계를 정상화하기 위한 보다 근원적인 방안으로 두 가지 정책안을 제시하고 이 정책을 정착시키고 성공시키기 위한 보건의료정책 거버넌스에 관한 제안을 담고 있다. 상급종합병원의 중증 환자 진료기능을 강화하기 위하여 현행 종별가산율을 외래와 입원 종별가산율로 분리하고 외래진료비 목표관리제 도입이라는 두 가지 방안을 제시하였다. 그리고 이들 정책안을 큰 부작용없이 성공시키기 위한 보건의료 정책 거버넌스를 제안하였다. 보건의료 정책 거버넌스는 의료공급자, 환자의 참여와 동기부여가 전제되어야 하며 장기적인 관점에서는 향후 의료 질을 반영할 수 있도록 설계되어야 한다.

• 대한장애인치과학회지
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• 제12권2호
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• pp.55-65
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• 2016

The objective of this study was to estimate the proper amount of subsidy required to operating dental hospital or clinic for the disabled. Models for estimating operating profit of general dental hospital/clinic and opportunity cost of operating dental hospital/clinic for the disabled was formulated. Data were collected from various sources such as the annual reports of Purme Hospital, one of the running dental hospitals for the disabled, statistics from Healthcare Bigdata Hub, operated by Health Insurance Review & Assessment Service of Korean Government, and the deliberation data of non-reimbursable treatments in Seoul Dental Hospital for the Disabled. A dental hospital/clinic for the disabled was less profitable than a general dental hospital/clinic, of which the reason is that the chair time for the average patient is longer. However, It was false that a dental hospital/clinic for the disabled scored less average insurance fee for a treatment. Disabled patients had more frequent prosthodontic treatments, which had a high average insurance fee. There were some groups of treatments that could yield higher profitability in a dental hospital/clinic for the disabled; recall checks, and periodontal treatments.

• 한국병원경영학회지
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• 제17권1호
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• pp.23-42
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• 2012

The purpose of this study is to identify the inpatient service quality at mental hospitals and to examine the effect of service quality on patient's overall satisfaction and customer loyalty. Data collection was done through conducting a survey of inpatients in three mental hospitals located in Chungnam, Korea using self administered questionnaire. The questionnaire included the modified version of 'service satisfaction scale for psychiatric patients' invented by Chul Kwon Kim and other members, which consists of five dimension of service quality: staff attitude, treatment quality, ward environment, access/cost and ward rule. Total 236 questionnaires were gathered and 219 were used for analysis. The data was analyzed by using version SAS9.2 and path analysis model was applied to test our hypothesis. As a result, the four factors of service (staff attitude, treatment quality, ward environment and ward rule) were extracted, which counted for 62.89% of the common variance. Moreover, Cronbach Alpha showed relatively high internal consistency of answer, all exceeding 0.6. According to the study, ward environment and treatment quality turned out to have direct influence on the patient's satisfaction. In addition, staff attitude and overall satisfaction directly influenced the customer loyalty while ward environment and ward rule indirectly had influence using overall satisfaction as a medium. In conclusion, in order to enhance the satisfaction and customer loyalty in mental hospitals, efforts in improving environmental service quality in particular is highly demanded.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.20-25
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• 2020

Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

• Archives of Reconstructive Microsurgery
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• 제26권1호
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• pp.9-13
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• 2017

Purpose: Fingertip amputations are the most common type of upper limb amputations. Composite grafting is a simple and cost-effective technique. Although many factors have investigated the success of composite grafting, the success rate is not high. Therefore, this study was conducted to investigate whether the microscopic procedure process during composite grafts improves the success rate. Materials and Methods: Thirteen cases of unreplantable fingertip amputation underwent a microscopic resection procedure for composite graft in the operating room. The principle of the procedure was to remove the least devitalized tissue, maximize the clean tissue preservation and exact trimming of the acral vessel and to remove as many foreign bodies as possible. Results: All fingertips in the thirteen patients survived completely without additional procedures. Conclusion: Composite grafting allows for the preservation of length while avoiding the donor site morbidity of locoregional flaps. Most composite grafts are performed as quickly as possible in a gross environment. However, we take noticed the microscopic resection. This process is thought to increase the survival rate for the following reasons. First, the minimal resection will maximize the junction surface area and increase serum imbibition. Second, sophisticated trimming of injured distal vessels will increase the likelihood of inosculation. Third, accurate foreign body removal will reduce the probability of infection and make it possible to increase the concentration and efficiency in a microscopic environment. Although there is a need for more research into the mechanisms, we recommend using a composite graft under the microscopic environment.

• Osong Public Health and Research Perspectives
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• 제9권6호
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• pp.314-324
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• 2018

Objectives: The aim of this study was to analyze research and development projects in mental health services in Korea, using priority evaluation of mental health promotion policies to determine direction of the service. Methods: An online survey was conducted that targeted experts in the mental health service regarding promotion of mental health in Korea in 2016. The survey was based on 32 policy projects that resulted from 12 strategies according to 4 policy objectives. Results: Analysis of 32 mental health projects were assessed regarding the possibility of technology development success, magnitude of the ripple effect, and necessity of a national response. It was observed that 3 policy projects relevant to suicide, had a high relative priority. This was followed by policies for improvement of health insurance and the medical benefit cost system, and policies for reinforcement of crisis psychological support such as those for disaster victims. Conclusion: The prioritization of mental health services should place an emphasis on promotion of a healthy mental lifestyle, rehabilitation support for patients with serious mental illness, and reinforcement of social safety networks for suicide prevention.

• 동의신경정신과학회지
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• 제32권3호
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• pp.141-154
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• 2021

Objectives: Pharmacopuncture is a Korean medicine treatment that combines acupuncture and herbal medicines. The aim of this study was to investigate the current usage status of pharmacopuncture for insomnia among Korean medicine doctors (KMDs). Methods: We conducted a self-reporting online survey targeting KMDs from February 23 to March 15, 2021 with cooperation of the Association of Korean Medicine. Responses of 957 KMDs were analyzed. Results: Types of pharmacopuncture mainly used in treatment for insomnia were placenta pharmacopuncture and Hwangryunhaedok-tang pharmacopuncture. Cephalic and facial region were preferred as the treatment site. For one treatment, total usage of pharmacopuncture was more than 0.5 cc but less than 1 cc. Among respondents, the largest number of respondents thought that clinical experience and patient symptoms were important as selection criteria of acupoints using Pharmacopuncture for insomnia. Average treatment duration of using Pharmacopuncture for insmonia was more than 4 weeks. Most KMDs preferred treatment for one to four times a week regarding the treatment cycle. The use of Pharmacopuncture for insomnia was recognized as having a good effect, although other KMDs were concerned about the insufficient evidence and the high cost due to non-reimbursement of pharmacopuncture therapy. Conclusions: In order to activate pharmacopuncture treatment for insomnia, it is necessary to secure effectiveness and safety through basic research, create evidence through clinical research, and reduce costs for patients.