• 제목/요약/키워드: Medical Access

검색결과 874건 처리시간 0.037초

우울과 의료이용의 관계 (Relationship between Depression and Health Care Utilization)

  • 조효은;이준협
    • 보건행정학회지
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    • 제34권1호
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    • pp.68-77
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    • 2024
  • 연구배경: 우울은 저하된 기분이 비교적 경미한 수준인 일상 우울과 병적 상태인 임상적 우울로 구분할 수 있다. 우울 경험은 치료순응도 저하, 신체증상 등을 경험하게 하여 의료이용을 높일 수 있으나 우울 중 임상적 우울 집단은 질환에 대한 사회적 편견을 경험하여 의료이용이 제한될 수 있다. 의료이용은 개인 나아가 사회 문제의 원인이 되어 중요하다는 측면에서 본 연구는 임상적 우울 집단, 일상 우울, 비우울 집단의 의료이용을 비교하여 살펴보고자 한다. 방법: 일반화 성향점수(generalized propensity score) 기반 처치역확률가중기법(inverse probability of treatment weighting)을 이용하여 비우울, 일상 우울, 임상적 우울 집단 간 공변량의 불균형을 최소화하고 우울과 의료이용, 총진료비의 관계를 각각 음이항 회귀분석과 로그변환한 선형회귀분석을 통해 확인하였다. 결과: 우울은 여성, 소득이 낮은 집단, 교육수준이 낮거나 배우자가 없거나 건강보험에 가입되지 않았거나 경제활동을 하지 않은 집단에서 높았으며, 우울중 임상적 우울은 경제활동을 하지 않거나 민간의료보험에 미가입된 집단, 질환의 보유개수가 많은 집단에서 비중이 높았다. 의료이용 횟수는 우울 집단(일상 우울 집단 및 임상적 우울 집단)이 비우울 집단보다 유의하게 높았으며, 임상적 우울 집단이 일상 우울 집단보다 유의하게 높았다. 총진료비는 우울 집단이 비우울 집단보다 높았으나, 임상적 우울 집단과 일상 우울 집단 간에는 유의한 차이가 없었다. 결론: 의료이용은 비우울 집단보다 우울 집단(임상적 우울 집단 과 일상 우울 집단)에서 높았으며, 임상적 우울 집단보다 일상 우울 집단에서 높았다.

개방형 동료심사 제도 채택 학술지 현황과 특성에 관한 연구 (An Investigation on the Features of Journals Implementing Open Peer Review)

  • 김나연;정은경
    • 정보관리학회지
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    • 제41권1호
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    • pp.537-560
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    • 2024
  • 오픈 과학으로 진화하는 학문 생태계 속에서 개방형 동료심사는 학술 커뮤니케이션의 투명성과 개방성을 강화하는 방안으로 주목받고 있다. 본 연구는 개방형 동료심사를 도입한 오픈액세스 학술지 118건을 대상으로 개방형 동료심사 제도 구성요소의 채택 현황과 출판사 유형, 국가·대륙별, 언어별, 학문 분야별 특성을 살펴보았다. 개방형 동료심사는 심사 보고서 또는 심사 전 논고를 공개하거나 저자와 심사자의 신원을 상호 간에 공개하는 등 다양한 방식으로 구현되었다. 또한 학문 분야별로 채택된 구성요소 간에 차이를 발견할 수 있었다. 출판사 유형별 비중이 큰 상업 출판사가 대체로 많이 채택한 것으로 나타났으며, 주로 유럽에 속하는 국가에서 영어로 발행되는 현황이다. 분야별로 살펴보면, 전통적으로 개방적인 학술 커뮤니케이션을 지향하는 의약학, 자연과학 분야에서 더욱 활발한 개방형 동료심사 제도를 찾아볼 수 있었던 반면, 복합학, 인문학 분야에서는 소수의 학술지를 찾아볼 수 있다. 이를 통해 개방형 동료심사 제도의 학술지 채택 현황을 파악할 수 있으며, 개방형 동료심사제도 채택에 따른 학술 커뮤니티의 특성에 대한 이해를 높일 수 있다.

가토의 정상폐의 고주파 유전형 가온에 관한 연구 (8MHz RF Capacitive Heating on Rabbit Lung)

  • 장홍석;김종우
    • Radiation Oncology Journal
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    • 제10권1호
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    • pp.1-6
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    • 1992
  • 온열요법은 최근 10년간 암치료요법의 한 방법으로 큰 관심을 끌어왔다. 그러나, 아직까지 폐종양에 대해서는 온열요법이 잘 시행되지 않고 있는 바, 이는 폐가 물리학적으로 공기를 함유한 비교적 가온하기 어려운 함기성기관이어서 이의 효과적인 가온에 대한 시도가 많지 않았기 때문으로 생각된다. 저자들은 고주파유전형 가온에 의한 폐의 가온효과를 평가하기 위하여 가온이 비교적 용이한 실성기관(solid organ)인 가토의 정상간과, 가토의 정상폐의 가온정도를 비교하고자 하였다. 실험 동물들을 폐 가온군과 간 가온군으로 각각 10마리씩 2개의 군으로 나누었으며, 다음과 같은 결과를 얻었다. 1) 폐 가온군에서 15분간 가온한 폐의 평균 온도는 $41{\pm}1.7^{\circ}C$이었고, 식도의 평균 온도는 $42{\pm}1.7^{\circ}C$이었다. 2) 간 가온군에서 15분간 가온한 간의 평균 온도는 $42.1{\pm}1.6^{\circ}C$이었고, 이때 피부의 평균 온도는 $39.5{\pm}1.4^{\circ}C$이었다. 3)$42^{\circ}C$까지의 가온에 소요된 시간은 폐 가온군 에서는 $9.3{\pm}1.8$분 이었고, 간 가온군 에서는 $5.7{\pm}0.7$분 이었다. 4)$42^{\circ}C$까지의 분당 열 증가율은 폐 가온군 에서는 $0.46{\pm}0.17^{\circ}C$/분 이었고, 간 가온군 에서는 $0.56{\pm}0.2^{\circ}C$/분 이었다. 5) 가온 온도가 $42^{circ}C$-$43^{\circ}C$ 도달시까지, 폐 가온군 에서의 RF총 평균 출력은 각각 $48{\pm}20W$$39{\pm}19W$이었으며, 폐 가온군이 간 가온군 보다 높았다(p<0.05). 6) 가온에의한 식도내 온도가 폐의 온도보다 $1.1{\pm}0.9^{\circ}C$높았다(p<0.05). 이상과같은 결과는 기낭성기관인 폐도 RF의 보다 높은 출력 이 소요되기는 하나 온열요법을 시행하였을 때 충실성기관인 간과 마찬가지로 종양치료에 유효한 $42^{\circ}C$-$43^{\circ}C$까지 잘 가온될 수 있음을 입증 하였다. 또한 폐의 온열요법시 종격동은 보다 높은 온도에 도달함으로 종격동의 열손상에 대한 고려가 필요함을 시사한다.

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Sensory Information Processing

  • Yoshimoto, Chiyoshi
    • 대한의용생체공학회:의공학회지
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    • 제6권2호
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    • pp.1-8
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    • 1985
  • The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70$\pm$1.32mmHg/min)compared to CF dialyzers(4.32$\pm$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500, 550, 570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500, 550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100, 300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3, 000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.SpO2 with Plethysmograph.

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N-methyl-D-aspartate glutamate 수용체 길항제 memantine의 투여가 C57BL/6형 생쥐의 알코올 섭취량에 미치는 영향 (Effect of N-Methyl-D-Aspartate Glutamate Receptor Antagonist, Memantine, on Alcohol Intake in C57BL/6 Mice)

  • 김현경;김성곤;김지훈;신수미;이상신;배소현;김호찬
    • 생명과학회지
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    • 제19권4호
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    • pp.532-537
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    • 2009
  • 알코올 의존과 N-methyl-D-aspartate (NMDA) 수용체와 밀접한 관계가 있을 수 있다는 연구들이 있는데, 즉 NMDA 수용체가 알코올의 금단, 내성의 발생과 관련이 있다는 연구 결과들이다. 그러나 NMDA 수용체 길항제가 알코올 의존의 재발 예방에 효과가 있을 것이라는 것에 대해서는 아직 논란이 되고 있다. 본 연구는 유전적으로 알코올을 선호하는 C57BL/6형 생쥐를 이용하여 유한접근법으로 NMDA 수용체 길항제인 memantine을 5, 25, 50 mg/kg으로 각각 투여하였을 때 알코올 섭취량에 미치는 영향을 알아보고자 하였다. 알코올 의존화된 C57BL/6형 수컷 생쥐를 5군으로 나눈 뒤, 12일간 각 군에 vehicle, naltrexone 1.0 mg/kg, memantine 5, 25, 50 mg/kg으로 각각 투여하면서 알코올의 섭취량, 물 섭취량, 사료 섭취량 및 체중을 조사하였다. 본 연구의 결과, 2시간 알코올 섭취량의 12일간 변화에 대해 vehicle 투여군과 naltrexone, memantine 5, 25, 50 mg/kg 투여군 각각의 군을 repeated measure ANOVA를 이용하여 비교하였을 때, naltrexone (df=4, F=11.827, p<0.01), memantine 5 mg/kg (df=4, F=7.999, p<0.01), memantine 25 mg/kg (df=4, F=6.199, p<0.05) 및 memantine 50 mg/kg (df=4, F=10.522, p<0.01) 투여군에서 각각 유의한 군과 일수의 상호작용을 보였다. 그러나 22시간 물 섭취량, 24시간 사료섭취량 및 체중의 12일간 변화에 대해서는 vehicle 투여군과 memantine 투여군 3군 각각에서 유의한 상호작용이 없었다. 한편, vehicle 투여군과 naltrexone 투여군 간에는 체중의 변화에서 유의한 군과 일수의 상호작용을 보였고, 22시간 물 섭취량 및 24시간 사료 섭취량에서는 유의한 상호 작용이 없었다. 이상의 결과는 NMDA 수용체 길항제인 memantine을 생쥐에게 투여하였을 때 알코올 섭취량에 영향을 줄 수 있다는 것을 의미한다. 이는 앞으로 부작용은 적으면서 치료 효과는 우수한 알코올 의존 재발 예방 치료제 개발의 가능성을 제안하고 있다.

소설과 말기 암환자를 통해 본 한국인의 죽음의 의미

  • 전혜원;김분한
    • 호스피스학술지
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    • 제3권2호
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    • pp.34-54
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    • 2003
  • Every one experiences death one day, however no one can knows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning I.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. 1.The death investigated in the fiction, was found as a progress of negative emotion, acceptance and sublimation, life related subjects in the negative emotion were tenacity for life, anxiety, lingering attachment, responsibility, abandonment and death related subjects were shock, isolation, fear, scare and rejection. Acceptance related subjects were acceptance, destiny, secularism, preparation and arrangement, and sublimation related subjects were sublimation through Christian and Buddhism. 2.The death showed in the participants was negative emotion, acceptance and sublimation, life related subjects were repentance, anxiety, responsibility and hopelessness, and death related subjects were dejection, solitude, anger, fear and scare. The acceptance was a type of religious acceptance that admitted instantly by reaching an understanding with the God, and death was accepted as a progress of preparation, arrangement, acceptance and hope. Sublimation related subjects were Christian sublimation and relief or destiny incurred from self-reflective sublimation through communications and thoughts. 3.The death in view of fiction and participants were positively accepted both death and negative emotion, and the study disclosed the fact that death was sublimated dependent on religion. 4.The progress of negative emotion, acceptance and sublimation was disclosed more complicated and various in the real end stage cancer patients and acceptance only found in the patients on the form of religious acceptance, according to the results compared with fiction and real end stage cancer patients. The death showed in the fiction was standardized, gradated and similar progress with psychological status of Kubler-Ross. However, death in the participants was showed complex and various feelings simultaneously, and sometimes they accepted death positively. The sublimation through religion was found in Buddhism and Christian in the fiction and mostly Christian in the participants due to a number of Hospice patients. It was found that negative emotion various types of death was more found in the participants than fiction. It is therefore necessary to study on the response of death in various types. In the participants death was incurred more systematic and variously, we knew that nursing practice focused on experience of participants is required and reality on death is much profound than we analyzed and presented, lots of situations and reactions should be premised because we can not completely rule out the negligence possibility of care mediation of participants. In caring for the facing death patients, we discovered and confirmed again through this study that the spiritual care should be needed as a mediation method.

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흰쥐에서 단감발효주가 알코올성 지방간 형성에 미치는 영향 (Effect of Sweet Persimmon Wine on Alcoholic Fatty Livers in Rats)

  • 남경숙;김주연;노상규;박중협;성언기
    • 한국식품영양과학회지
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    • 제40권11호
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    • pp.1548-1555
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    • 2011
  • 본 연구에서는 흰쥐를 이용, 단감발효주의 항산화성과 알코올성 지방간 증상 완화에 미치는 영향을 조사하였다. Lieber-DeCarli 액체 표준식이만 공급받는 동물군을 대조군, 에탄올에 의한 열량 보충으로 대조군과 동일 열량의 액체식이를 공급받은 에탄올군, 에탄올군과 동일한 양의 알코올을 함유하는 단감발효주가 혼합된 액체식이를 공급받는 단감발효주군으로 하여 7마리씩 3그룹으로 나누어 6주간 사육하였다. 시작 전, 3주째, 그리고 6주째에 혈액을 채취하였고 간은 6주 혈액 채취 직후 적출되었다. 단감발효주의 총 페놀함량은 24.59 mg/100 mL이었고 SOD 유사활성은 20.9%이었으며 DPPH 라디칼 소거능은 27%로 나타났다. 6주간의 체중증가율은 대조군과의 비교에서 에탄올군에서는 유의적으로 감소되었으나 에탄올군과 단감발효주간의 비교에서는 차이가 없었다. 혈액의 중성지방 농도는 에탄올군과 단감발효주군에서 유의적으로 감소되었다. 혈액의 ALT, AST 농도는 대조군에 비해서 에탄올군에서 유의적으로 증가되었으나 단감발효주군에서는 유의적으로 감소하였다. 간조직의 사진촬영에서와 유사하게 간조직의 총지방량은 대조군에 비해 에탄올군에서 유의적으로 증가되었고 단감 발효주군에서는 유의적으로 감소하였다. 간조직의 주요 지방 종류별 총지방산 비교에서도 중성지방 분획의 지방산들은 에탄올군에서 유의적으로 증가되었으나 단감발효주군에서는 유의적으로 감소되는 경향을 보였다. 본 실험을 통해 단감발효주가 알코올 섭취로 증가된 혈중 지질 수준과 간기능 지표 수준을 개선시키는 효과를 나타냈으며 지방간 형성이 유의적으로 억제되는 것을 간조직 지방분석을 통해 확인하였다. 이는 전통기능성주인 단감발효주에 포함된 다양한 폴리페놀이 알코올에 의한 간 손상을 보호하는데 기여할 수 있음을 증명한 실험결과로 판단된다.

전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향 (Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia)

  • 김지윤;이동원;서일숙;김세연
    • Journal of Yeungnam Medical Science
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    • 제24권2호
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    • pp.206-215
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    • 2007
  • 복와위는 신체 후부 노출이 필요한 척추 수술을 위해 주로 사용되고 있으며 수술부위로의 접근이 용이하고 수술 도중에 척추를 안정적으로 유지해주는 장점이 있다. 하지만 전신마취하에 있는 환자를 앙와위에서 복와위로의 전환은 여러 가지 부작용을 동반하며 특히 순환기계의 변화를 초래할 수 있다. 이를 줄이기 위해 다양한 복와위 전용 수술대들이 연구 개발되어 임상에 사용되고 있다. 이에 저자들은 앙와위에서 복와위로의 체위 변환 시에 Jackson spinal surgery table의 이용이 체위에 의한 압박 때문에 생기는 환자의 순환기계 변화를 얼마나 효과적으로 줄여줄 수 있는지 알아보고자 하였다. 본 연구는 추간판탈출증, 퇴행성척추전방전위증, 척추협착증의 진단 하에 본원 정형외과와 신경외과에서 수술을 받기로 예정된 환자 중 미국 마취과학회 신체등급 분류 1급 또는 2급에 해당하는 성인 환자 30명을 대상으로 하였다. 연구 대상 환자의 성별은 남자가 15명, 여자가 15명이었고, 심혈관계나 호흡기계 질환이 있는 환자는 연구 대상에서 제외하였다. 모든 환자는 마취전투약으로 수술 시작 1시간 전에 glycopyrrolate 0.2 mg, fentanyl $1{\mu}g/kg$을 근주하였으며 수술실에 도착한 후 비침습적 자동 혈압 측정기, 심전도 및 맥박산소 계측기를 거치하였다. Thiopental sodium과 vecuronium으로 마취를 유도하였으며 환자의 의식소실과 충분한 근이완을 확인한 후 기관내 삽관을 시행하였다. Enflurane 1.5-2.0 vol%와 $O_2$, $N_2O$ 각각 2 L/min을 사용하여 마취유지를 하였으며 급격한 활력 징후의 변동으로 마취유지가 용의치 않은 경우는 연구 대상에서 제외시켰다. 환자의 활력 징후 안정 후 요골 동맥에 카테터를 거치하여 지속적으로 동맥압을 측정하였고, 우측 쇄골하 정맥에 중심정맥 카테터를 거치하여 중심정맥압을 측정하였다. 부분재호흡 심박출량 감시기 ($NICO^{(R)}$, Novametrix Medical Systems INC., USA)를 통해 비침습적으로 환자의 심박출량을 측정하였다. 앙와위에서 복와위로 체위변경 직전에 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 앙와위의 값으로 삼았으며, 척추 수술 전용 수술대인 Jackson spinal surgery table을 사용하여 복와위를 취하였다. 복와위로 체위 변경 뒤 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 복와위의 값으로 기록하였다. 본 연구 결과 앙와위와 복와위의 혈역학적 지수의 비교시 심박수와 평균동맥압은 별다른 차이가 없었다. 중심정맥압은 유의한 정도는 아니지만 감소 소견을 보여 수술시 출혈의 위험성을 감소시킬 것으로 생각된다. 심박출량과 심박출 계수도 유의한 감소 소견을 보였으나 convex saddle table을 이용한 경우와 kneechest position을 취한 경우보다 적은 변화를 보여 Jackson spinal surgery table의 사용은 유용할 것으로 사료된다. 그러나 Jackson spinal surgery table을 사용하여 복부와 흉부에 과도한 압력이 가해지지 않더라도 유의한 심박출량 감소가 있을 수 있음을 유념해야 할 것이다. 특히 심폐여력이 부족한 환자들에 있어서는 심박출량의 감소는 위험한 결과를 초래할 수 있으므로 복와위에 의한 생리적 변화에 관한 충분한 이해와 함께 마취 시 보다 적극적인 감시와 관리가 요구된다고 여겨진다.

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사회 네트워크를 이용한 사용자 기반 유헬스케어 서비스 추천 시스템 개발 (Development of User Based Recommender System using Social Network for u-Healthcare)

  • 김혜경;최일영;하기목;김재경
    • 지능정보연구
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    • 제16권3호
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    • pp.181-199
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    • 2010
  • 인구의 고령화 및 건강에 대한 관심이 증가됨에 따라 유헬스케어 서비스는 발병 후 관리관점에서 발병 전의 예방 관점으로 그 목적이 점차 이동하고 있다. 그러나 기존의 유헬스케어 서비스는 원격진료 차원의 의료 서비스 성격이 강하여, 만성 성인병과 같은 대사 증후군을 예방 및 관리하기에는 한계가 있을 뿐만 아니라, 관리자 중심의 단방향 서비스를 제공함으로 인해 사용들이 중도에 이용을 포기하는 비율이 높았다. 이와 같은 문제를 해결하기 위하여, 본 연구에서는 사회 네트워크를 이용한 사용자 기반 유헬스케어 서비스 추천 시스템을 제안하였으며, 실세계에서 유헬스케어 서비스 추천 시스템의 활용 가능성을 제시하기 위하여 실제 의료원에서 대사 증후군 예방 및 관리를 위해 처방한 식단 및 운동 정보를 기반으로 유비쿼터스 컴퓨팅 환경에서 적용가능한 시스템을 구현하였다. 본 연구에서 제안한 시스템은 사용자가 선호하지 않는 서비스가 네트워크를 통해 확산될 가능성을 낮추는 동시에 추천의 신뢰성 제고를 위해 네이버들이 이용한 서비스를 공유함으로써 전체적인 추천 품질을 높인다. 즉, 사용자의 식습관 및 운동습관 등과 같은 생활습관을 개선하기 위하여 사회 네트워크를 활용함으로써 사용자간의 자율협업을 통한 개인화된 추천이 가능하다. 따라서 본 연구에서 제안하는 유헬스케어 서비스 추천 시스템은 생활습관 개선을 위하여 사용자에게 적합한 식단 및 운동을 제공하고, 생활습관의 개선을 통해 만성 성인병과 같은 대사증후군을 사전에 예방할 수 있을 것으로 기대된다.

과산화수소의 농도와 적용시간이 상아질의 깊이에 따라 레진 수복물의 미세인장결합강도에 미치는 영향 (THE EFFECT OF CONCENTRATION AND APPLICATION TIME OF HYDROGEN PEROXIDE ON THE MICROTENSILE BOND STRENGTH OF RESIN RESTORATIONS TO THE DENTIN AT DIFFERENT DEPTHS)

  • 손정룡;이계영;강유미;오영택;이광원;김태균
    • Restorative Dentistry and Endodontics
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    • 제34권5호
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    • pp.406-414
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    • 2009
  • 본 연구의 목적은 심부 상아질과 치수실 상아질에 $H_2O_2$를 각기 다른 적용시간과 농도로 적용하였을 때, 레진수복물과의 미세인장결합강도에 미치는 영향을 평가하는 것이다. 준비된 각각의 치아에 전형적인 근관와동을 형성하고 다음과 같이 무작위로 1개의 대조군과, 4개의 실험군으로 나누었다: 1군, 전처리를 시행하지 않았다; 2군, 20% $H_2O_2$를 20분, 10분, 5분간 적용하였다; 3군, 10% $H_2O_2$를 20분, 10분, 5분간 적용하였다; 4군 5% $H_2O_2$를 20분, 10분, 5분간 적용하였다; 5군, 2.5% $H_2O_2$를 20분, 10분, 5분간 적용하였다. 위와 같이 처리한 후 와동 내를 Superbond C&B(Sunmedical, Co., Shiga, Japan)로 충전하였다. 각 치아는 $37^{\circ}C$ 증류수에 24시간 저장한 뒤 심부 상아질과 치수실 상아질로 잘라 미세인장결합강도 시험을 시행하였다. 각 군에서 측정된 미세인장결합강도를 3-way ANOVA와 Tukey post hoc test로 통계 처리하였다(p < 0.05). 실험 결과 모든 군에서 심부 상아질(D1)의 미세인장 결합강도가 치수실 상아질(D2)보다 높게 나타났다. 평균 결합강도는 $H_2O_2$의 농도와 적용 시간이 증가할수록 감소하였다. 통계분석에서 상아질의 깊이, $H_2O_2$ 농도와 적용 시간이라는 세 가지 변수간의 교호작용 효과는 없으나(p > 0.05). 상아질의 깊이와 $H_2O_2$ 농도 사이, $H_2O_2$ 농도와 적용 시간 사이에서는 교호작용 효과가 있었다(p < 0.05). SEM 관찰에서는 $H_2O_2$의 농도가 증가할수록 상아세관이 좀 더 개방된 양상을 보였다.