• 한국인터넷방송통신학회논문지
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• 제11권2호
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• pp.253-259
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• 2011

유비쿼터스(Ubiquitous) 시대에 통합의학을 이용한 간단한 건강상태의 진단은 시간과 장소, 컴퓨터 여건에 구애받지 않고 언제 어디서나 네트워크에 접속할 수 있는 환경에서 서비스를 받을 수 있다. 이러한 유비쿼터스 세상을 선도하는 핵심 중 하나가 모바일 인터넷이고, 가장 많이 사용되는 매개체는 모바일폰이다. 그 중심이 되는 모바일폰을 이용한 건강관리는 바쁜시대를 살아가는 현대인에게는 꼭 필요한 요소라 할 수 있다. 모바일폰에서 제작된 사진, 동영상, 녹음소리 등의 콘텐츠를 모바일 카페(Cafe), 블로그(Blog), 미니홈페이지(Mini Homepage) 등에 연동하기 위해서 왑서비스를 중단하고 모바일 콘텐츠를 업로드한 다음 다시 접속하여야 하는 불편함을 가지고 있는 점이 있다. 이에 본 논문에서는 모바일폰 사용자가 왑(WAP)서비스 접속중 서비스를 종료하지 않고 모바일폰으로 촬영된 다양한 사진, 동영상, 녹음소리 등을 왑서비스 이용환경에서 업로드가 지원되고 통합의학적 진단의 내용들이 카테고리별로 콘텐츠가 분류되어 관리 될 수 있는 콘텐츠관리시스템을 설계 및 구현 하였다.

• 한국의학물리학회지:의학물리
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• 제3권2호
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• pp.43-57
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• 1992

위상감지법(phase detector technique)은 세포의 막 캐패시턴스(membrane capacitance)를 실시간적으로 측정할 수 있는 유일한 방법이나 측정이 행해지는 동안 세포의 상태가 끊임없이 변화하기 때문에 피할 수 없는 측정오차가 존재한다. 본 연구는 이 오차의 근원을 분석하여 위상감지법의 실용한계를 규정하고자 하였다. 이론적 분석에 기초하여 다음과 같은 사실을 밝힐 수 있었다. 1) access conductance와 membrane conductance의 변화에 기인하는 측정오차를 줄이기 위해서는 초기 위상치를 올바로 선택하여야 한다. 2) 이 때 세포를 여기시키기 위해 인가하는 전압의 주파수를 알맞게 선택하여야 한다. 3) 그러나 초기 위상치가 정해진 이후의 위상 변화는 막 캐패시턴스의 측정에 큰 영향을 미치지 않는다. 4) 초기 위상을 적절히 선택하였다 하더라도 세포외 분비시 막 캐패시턴스가 크게 증가하는 경우에는 비례상수에 오차가 발생한다. 이 때 발생하는 오차는 측정기간 동안 비례상수를 되풀이하여(iteration) 보정함으로써 방지할 수 있다. 이상의 결과는 향후 위상감지법을 사용할 때 유용한 설용한계를 제공하리라 생각된다.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.732-739
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• 2021

Objective : Early successful reperfusion is associated with favorable outcomes in acute ischemic stroke (AIS). The purpose of this study was to achieve successful recanalization by a combined mechanical thrombectomy technique, the Aspiration-Retriever Technique for Stroke (ARTS), which is composed of a flexible large lumen distal access catheter and a retrievable stent as the first-line strategy of mechanical thrombectomy. Methods : We retrospectively reviewed 62 patients with AIS who underwent mechanical thrombectomy from 2018 to 2019 at our institute by a senior neurointerventionalist. Among them, patients who were treated using the ARTS technique with the soft torqueable catheter optimized for intracranial access (SOFIA^®; MicroVention-Terumo, Tustin, CA, USA) as the first-line treatment were included. Patients who had tandem occlusions or underlying intracranial artery stenosis were excluded. The angiographic and clinical outcomes were evaluated. The angiographic outcome was analyzed by the rate of successful recanalization, defined as a Thrombolysis in Cerebral Infarction score of 2b or 3 at the end of all procedures and the rate of successfully achieving the first pass effect (FPE), defined as complete recanalization with a single pass of the device. The clinical outcomes included the National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS), and mortality. Results : A total of 27 patients (mean age, 59.3 years) fulfilled the inclusion criteria. The successful recanalization rate was 96% (n=26) while the FPE rate was 41% (n=11). The mean post-procedural NIHSS change was -3.0. Thirteen patients (48%) showed good clinical outcomes after thrombectomy with the ARTS technique (mRS at 90 days ≤2). Postoperative complications occurred in seven of 25 patients : hemorrhagic transformation in six patients (22%) and distal embolization in one patient (4%). Mortality was 15% (n=4). Conclusion : Although the clinical outcomes using the ARTS technique with a flexible large lumen distal access catheter performed as the frontline thrombectomy in patients with AIS were not significantly superior than those of other studies, this study showed a high rate of successful endovascular recanalization which was comparable to that of other studies. Therefore, ARTS using the SOFIA^® catheter can be considered as the first choice of treatment for AIS due to large vessel occlusion.

• 한국임상수의학회지
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• 제35권1호
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• pp.10-12
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• 2018

Mitral regurgitation is the most frequent cause of cardiac disability and death in dogs. A wide range of medical and surgical treatments have been used for mitral regurgitation. Surgical treatments for complete correction of mitral regurgitation include valve repair and valve replacement, which have the advantages of eliminating or correcting the primary cause. Surgical treatments approach the mitral valve via right- or left-side thoracotomy. Aortic root exposure is needed for cardiopulmonary bypass. To compare right-side and left-side approaches, 10 dog cadavers were used in this study. Subsequently, the left-side surgical approach was used in vivo and in conjunction with cardiopulmonary bypass and cardioplegic arrest. Based on the results, and considering ease of access to the aortic root, valve incision site, and visualization of the surgical field, a left-side approach is recommended.

• 보건행정학회지
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• 제9권2호
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• pp.139-156
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• 1999

Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.237-241
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• 1986

본 교실에서 백서의 대퇴동맥을 이용하여 혈관감자의 회전없이 continuous suture로 미세혈관 문합을 시행해본 결과 다음과 같은 결론을 얻었다. end-to-end anastomosis시 double c1app의 회전이 어려울 정도로 작업공간이 제한된 경우나 end-to-side anastomosis시 secondary Vessel의 길이가 짧아서 후벽을 잘 볼 수 없는 경우에 continuous suture을 이용하면 Back wall을 완전히 노출시킨 상태에서 쉽게 혈관 문합을 시행할 수 있으며 문합시간도 단축시킬 수 있을 것으로 사료된다.

• 대한임상독성학회지
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• 제15권1호
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• pp.47-50
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• 2017

Nitrogen is an inert gas that is harmless to humans under normal conditions. While it is not inherently toxic, nitrogen gas becomes dangerous when it displaces oxygen, resulting in suffocation. Herein, we report a case of a 34-year-old man who attempted suicide by nitrogen asphyxiation who presenting with decreased mental function and agitation. Lactic acidosis and hyperammonemia were observed on presentation at the emergency department, but these improved after a few hours. After 2 days, the patient regained full consciousness, and was discharged without any complications. Survival after asphyxiation due to nitrogen gas is very rare, and these patients are more likely to have poorer outcomes. There is a potential for the increasing use of nitrogen gas as a method of committing suicide because of the ease of access to this gas.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.411-418
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• 2006

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

• 대한한의학방제학회지
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• 제21권2호
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• pp.121-132
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• 2013

Objectives : The objectives of this study is to establish data-base to find out similar herbal formulas with a particular herbal formula by comparing composition ratio of configuring herbs. And this thesis is to analyze differences of prescriptions and find out similar prescriptions by utilizing galenical mass ratio, which is directly related to effectiveness of galenical. Methods : This study was proceeded by using Access 2007 with Window 7(MS) and 2,787 prescriptions of which herbal configuration could be indicated by weight unit were analysed from Donguibogam. We standardize all units of the prescription and input the mass ratio data when entered galenical data. Results : We could confirm a degree of similarity between compared prescriptions and a particular prescription according to the sum of differences of herb weight ratio and similarity ratio. Conclusions : A most similar herbal formula could be searched through comparing multi prescriptions by multi prescriptions of herbal configuration from established herbal formula data-base where herb weight ratio of prescriptions is to be input.

• Korean Journal of Radiology
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• 제25권1호
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• pp.55-61
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• 2024

Objective: This study aimed to evaluate the safety and efficacy of intranodal lymphangiography and thoracic duct embolization (TDE) for chyle leakage (CL) after thyroid surgery. Materials and Methods: Fourteen patients who underwent intranodal lymphangiography and TDE for CL after thyroid surgery were included in this retrospective study. Among the 14 patients, 13 underwent bilateral total thyroidectomy with neck dissection (central compartment neck dissection [CCND], n = 13; left modified radical neck dissection (MRND), n = 11; bilateral MRND, n = 2), and one patient underwent left hemithyroidectomy with CCND. Ten patients (76.9%) had high-output CL (> 500 mL/d). Before the procedure, surgical intervention was attempted in three patients (thoracic duct ligation, n = 1; lymphatic leakage site ligation, n = 2). Lymphangiographic findings, technical and clinical successes, and complications were analyzed. Technical success was defined as the successful embolization of the thoracic duct after access to the lymphatic duct via the transabdominal route. Clinical success was defined as the resolution of CL or surgical drain removal. Results: On lymphangiography, ethiodized oil leakage near the surgical bed was identified in 12 of 14 patients (85.7%). The technical success rate of TDE was 78.6% (11/14). Transabdominal antegrade access was not feasible due to the inability to visualize the identifiable cisterna chyli or a prominent lumbar lymphatic duct. Among patients who underwent a technically successful TDE, the clinical success rate was 90.1% (10/11). The median time from the procedure to drain removal was 3 days (with a range of 1-13 days) for the 13 patients who underwent surgical drainage. No CL recurrence was observed during the follow-up period (ranging from 2-44 months; median, 8 months). There were no complications, except for one case of chylothorax that developed after TDE. Conclusion: TDE appears to be a safe and effective minimally invasive treatment option for CL after thyroid surgery, with acceptable technical and clinical success rates.