• 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.

• 한국생물정보학회:학술대회논문집
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• 한국생물정보시스템생물학회 2003년도 제2차 연례학술대회 발표논문집
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• pp.66-72
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• 2003

Toxicogenomics is now emerging as one of the most important genomics application because the toxicity test based on gene expression profiles is expected more precise and efficient than current histopathological approach in pre-clinical phase. One of the challenging points in Toxicogenomics is the construction of intelligent database management system which can deal with very heterogeneous and complex data from many different experimental and information sources. Here we present a new Toxicogenomics database developed as a part of 'Toxicogenomics for Efficient Safety Test (TEST) project'. The TEST database is especially focused on the connectivity of heterogeneous data and intelligent query system which enables users to get inspiration from the complex data sets. The database deals with four kinds of information; compound information, histopathological information, gene expression information, and annotation information. Currently, TEST database has Toxicogenomics information fer 12 molecules with 4 efficacy classes; anti cancer, antibiotic, hypotension, and gastric ulcer. Users can easily access all kinds of detailed information about there compounds and simultaneously, users can also check the confidence of retrieved information by browsing the quality of experimental data and toxicity grade of gene generated from our toxicology annotation system. Intelligent query system is designed for multiple comparisons of experimental data because the comparison of experimental data according to histopathological toxicity, compounds, efficacy, and individual variation is crucial to find common genetic characteristics .Our presented system can be a good information source for the study of toxicology mechanism in the genome-wide level and also can be utilized fur the design of toxicity test chip.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.156-163
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• 2023

Background: Interest in digital medical information has increased because it allows doctors to easily access a patient's medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians' thoughts and attitudes toward introducing blockchain technology into the medical field. Methods: This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree). Results: The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5-4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3-4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018). Conclusion: When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants' perceptions are essential factors to consider when introducing technology in the medical field.

• 전기학회논문지
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• 제60권1호
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• pp.167-173
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• 2011

Most of the terminologies used in medical domain is not intended to be applied directly in clinical setting but is developed to integrate the terms by defining the reference terminology or concept relations between the terms. Therefore, it is needed to develop the subsets of the terminology which classify categories properly for the purpose of use and extract and organize terms with high utility based on the classified categories in order to utilize the clinical terms conveniently as well as efficiently. Moreover, it is also necessary to develop and upgrade the terminology constantly to meet user's new demand by changing or correcting the system. This study has developed a mapping tool that allows accurate expression and interpretation of clinical terms used for medical records in electronic medical records system and can furthermore secure semantic interoperability among the terms used in the medical information model and generate common terms as well. The system is designed to execute both 1:1 and N:M mapping between the concepts of terms at a time and search for and compare various terms at a time, too. Also, in order to enhance work consistency and work reliability between the task performers, it allows work in parallel and the observation of work processes. Since it is developed with Java, it adds new terms in the form of plug-in to be used. It also reinforce database access security with Remote Method Invocation (RMI). This research still has tasks to be done such as complementing and refining and also establishing management procedures for registered data. However, it will be effectively used to reduce the time and expenses to generate terms in each of the medical institutions and improve the quality of medicine by providing consistent concepts and representative terms for the terminologies used for medical records and inducing proper selection of the terms according to their meaning.

• 한국수정란이식학회지
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• 제26권2호
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• pp.141-145
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• 2011

Seven male Himalayan tahrs were strongly assumed to have accidently fed on foreign bodies in 2007. At the time, zoo caretakers witnessed missing fence padding, such as carpet, plastic awning, and ropes. The incident occurred the morning after the items had been set up to protect indigenous, wild long-tailed gorals from self injury caused by head butting the steel fence. Adult male Himalayan tahrs were obviously suspected of mostly eating the paddings mainly composed of carpet, thin and long plastic awning, and ropes. Even though they had not shown digestive problems, surgery was determined necessary in order to remove any indigestible foreign bodies. Left flank rumenotomy was conducted on seven male Himalayan tahrs from April to May, 2011. After anesthesia with xylazine, rumenotomy was performed on a concrete floor, with legs and head secured by ropes. No access to water and hay prior to operation for two days was needed to make the surgical procedure done quickly. Two sheets of small hand towels protecting against inflow of ruminal contents were beneficial during surgery. Antibiotics were administered intramuscularly for seven days. No abscesses at the surgical site were found after surgery. Like domestic ruminants, wild ruminants also ingest metalic or non-metalic, indigestible foreign bodies by accident. Therefore, simplified rumenotomy must be developed to apply to those wild animals to lengthen their longevity and to advance the quality of life in captivity. This case report is the first showing how to perform rumenotomy of Himalayan tahr, a wild ruminant, in Korea.

• 대한의생명과학회지
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• 제12권1호
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• pp.9-16
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• 2006

We investigated the effects of 835-MHz electromagnetic field (EMF), one of the most popular communication frequency band in Korean code-division multiple-access (CDMA) mobile phone system, on cellular signal transduction. For this, we examined the change of intracellular calcium $([Ca^{2+}]_i)$, reactive oxygen species (ROS) and F-actin polymerization after exposure to 835-MHz EMF followed by the treatment of agonists in Rat-2 fibroblast cells. Culture cells were pretreated with serum-tree medium and concomitantly exposed to 835-MHz at specific absorption rate (SAR) of 4.0 W/kg for 24 hr in a specialized designed apparatus based on Transverse Electro Magnetics (TEM) wave theory. Intracellular $Ca^{2+}$ responses to lysophosphatidic acid (LPA) and epidermal growth factor (EGF) in Rat-2 fibroblast after exposure to 835-MHz EMF were shown to be similar pattern as observed in normal cultured cells. However, the LPA-induced calcium spiking was slightly delayed to 7 sec and sustained thereafter to a little higher ground level under 835-MHz EMF radiation compared to unexposed cells. ROS production level by LPA in the exposed cells was not different from that in control. Furthermore, LPA induced the production of stress fibers with no significant difference in the exposed and unexposed cells. These results suggest that mobile phone radiation (835-MHz, SAR 4.0 W/kg) may not be directly related to signal transduction in Rat-2 fibroblasts except the slight effect of calcium spiking in LPA-induced cells but remain to be further elucidated for possible indirect intervention.

• 한국의학물리학회지:의학물리
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• 제23권4호
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• pp.303-308
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• 2012

뇌정위 방사선수술의 선량계산을 위해 Geant4 기반의 응용 프로그램을 개발 하였다. 선형가속기에서 발생하는 방사선의 스펙트럼을 입력하기 위하여 사전에 실행하여 구한 스펙트럼에 각 에너지별로 구한 가중치를 곱하여 확률밀도를 구하였다. 이를 누적밀도로 변환하여 입력하도록 하였다. 메신저 클래스를 이용하여 다양한 형태의 MLC 조사면을 설정할 수 있도록 하였다. 갠트리와 테이블의 회전을 모사하기 위하여 rotateX와 rotateY라는 회전행렬을 사용하였다. 월드좌표 속에서 갠트리와 테이블을 정의하여 각각 회전을 구현하였다. 실제 환자의 자료는 CT의 dicom 파일에서 픽셀 크기, 매트릭스 크기 등의 정보와 픽셀의 HU를 밀도로 변환한 파일을 생성한 다음 이 파일을 이용 환자의 모델링에 이용 하였다. 환자의 모델링은 팬텀월드 안에 픽셀의 크기에 해당하는 복셀을 정의하고 이 복셀에 픽셀의 밀도와 이 밀도에 해당하는 물질을 할당해주었다.

• 대한한의학원전학회지
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• 제29권4호
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• pp.37-52
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• 2016

Objectives : The paper seeks to delve into a study of smallpox, specifically as one of the most representative contagious diseases during the Chosun era and how it was treated during that time. The lack of traditional medical texts that deal with smallpox has led this paper to dive into Duchanggyeongheombang. Methods : Everything related to edition and copy, and the author was organized based on pre-existing studies. The copy that is assumed as the original copy was considered and studied. The book was compared to and reviewed with Donguibogam, and the differences between the book and Korean translation were given attention as well. Results : Park Jin-hee is assumed to have authored Duchanggyeongheombang, and it is like that was had access to texts published by the state, one of which includes Donguibogam. He utilized the periods with smallpox outbreaks as his frame of study and put together a series of treatment for different symptoms. To this, he attached various medical charts, and added Korean translation for higher usability. In his book, he placed emphasis on spleen and stomach, but when needed, he did not shy away from using cold and coolness herbs. Conclusions : Duchanggyeongheombang was influenced partially by Donguibogam, but the book was given new life through the author Park Jin-hee's edition. Medical charts were added to increase its usability, and Korean translation was provided for wider audience. Its scope of prescription is very wide, and it provided the reasonings behind its medical judgements based on actual clinical studies instead of being tied down to traditions or taboos.

• 한국학교보건학회지
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• 제29권2호
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• pp.81-89
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• 2016

Purpose: This study is to analyze influencing factors of smoking intention among nonsmoking middle school students with regard to smoking attitude, knowledge and social influence. Methods: Data were collected from non smoking students of 5 middle schools in D metropolitan city. The 1,892 enrolled subjects provided informed voluntary consent prior to completing a structural questionnaire covering smoking attitudes, knowledge, social influences and general characteristics. The data were analysed using SPSS/Win 21.0 program by -test and logistic regression analysis. Results: Among the nonsmoking students, 85.5% never had an intention to smoke. In relation to general characteristics, smoking intention was significantly associated with sex, school records, socioeconomic status, relationship with parents, smoking experience, and smokers around them. In relation to attitude, knowledge, and social influence, smoking intention was significantly associated with a lower attitude score, a lower knowledge score, and a lower social norm. In the logistic regression analysis, smoking intention was associated with a lower attitude score (2.99 times), a lower social norm (2.65 times), being male (2.35 times), low socioeconomic status (2.22 times). and having smoking experience (2.70 times). Conclusion: It is needed to develop promotional strategies that could provide adjusted systematic smoking prevention education for the preferred smoking group and afford smoking prevention programs considering subject characteristics to help young adolescents avoid access to smoking in their early age.

• 보건행정학회지
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• 제30권3호
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• pp.335-344
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• 2020

Background: The purpose of this study was to identify factors inhibiting access of people with disability to health check-ups as well as identify pertinent solutions for improvement. Methods: Twenty-three people with disability older than the age of 19 who took respective health check-ups within the last 3 years were selected as participants. For the data collection, the 1:1 intensive interview was used. The data were analyzed by the grounded theory by Corbin and Strauss. Results: The results comprised nine categories, 23 subcategories, and 179 concepts. The central phenomenon was 'failure to obtain check-ups.' Causal conditions were observed as a 'lack of communication method,' 'physical difficulties,' and 'staff unfamiliar with people with disability,' Interventional conditions comprised 'physical accessibility,' 'staffs' competency,' and 'assistant manpower.' The active strategy was included 'to investigate the professional medical institution,' 'to find the medical institution of convenient traffic accessibility,' 'to overcome communication difficulties through equipment,' and 'to overcome linguistic barriers through sufficient communication.' Whereas, 'utilization of ancillary equipment,' 'the education of staffs on people with disability,' 'universal design manual,' and 'customized check-ups' were included in the passive strategy. Such processes arose in the contextual conditions of 'lack of expectations for daily lives' and 'lack of government support.' As a consequence, the subjects participated experienced the 'disadvantages,' 'discrimination,' and 'reduced reliability of the health check-ups.' Conclusion: The subjects who participated in this study emphasized 'staffs familiar with people with disability' and 'systems customized for people with disability' are mandatory to secure complete health check-ups for people with disability.