• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제12권1호
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• pp.94-102
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• 2001

최근 학교 아동들 사이에 집단따돌림현상이 문제화되고 있다. 학급에서 여러명의 학생이 특정 학생을 놓고 집중적으로 괴롭히고 따돌리는 현상은 비단 따돌림을 당하는 아동뿐만 아니라, 따돌림을 하는 아동들에게도 부정적인 영향을 미칠 수 있다. 이러한 따돌림의 원인은 다양하며 그중 따돌리거나 따돌림을 당하는 아동의 인격적 측면도 중요하리라 생각된다. 따라서 본 연구는 집단 따돌림의 피해군, 가해군, 피해 및 가해군과 무경험군 사이에 인격성향의 차이점이 있는지를 알아보고자 하였다. 1999년 3월부터 1999년 8월까지 서울에 소재한 초등학교 6학년에 재학중인 아동 215명(남자 115명, 여자 100명)을 대상으로 하였다. 아동과 아동의 보호자에게 집단따돌림의 여부에 관한 설문지를 배부하여 조사하였으며 아동의 보호자에게 한국아동인성검사(Korean Personality Inventory for Children, 1997)를 실시하여 아동에 관한 자료들을 조사하였다. 자료분석은 SPSS version 통계 처리 프로그램을 사용하였고 각 집단간 차이는 ANOVA, post hoc scheffe test, Student’s t-test로 분석하였다. 연구의 결과는 다음과 같았다. 1) 피해군, 가해군, 피해 및 가해군과 무경험군은 각각 11명(5.1%), 56명(26.0%), 11명(5.1%), 137명(63. 7%)이었다. 2) 따돌림피해의 빈도에 있어 1회 15명(7.0%), 2회 4명(1.9%), 3회이상 3명(1.4%)이었다. 또한 따돌림 가해빈도는 1회 40명(18.6%), 2회 17명(7.9%), 3회이상 10명(4.7%)이었다. 3) 집단따돌림의 피해군, 가해군, 피해 및 가해군과 무경험군에 있어 한국아동인성검사상 결과는 다음과 같았다. (1) 무경험군에 비하여 피해군은 자아탄력성(p=.00)척도가 유의하게 낮았으며, 과잉행동(p=.00), 정신증척도(p<.01)는 유의하게 높았다. (2) 무경험군에 비하여 피해 및 가해군은 자아탄력성척도(p=.00)가 유의하게 낮았고, 신체화(p=.00). 과잉행동척도(p=.00)는 유의하게 높았다. (3) 가해군에 비하여 피해군은 사회관계(p=.00), 정신증(p<.01), 자폐증척도(p=.00)가 유의하게 높았다. (4) 가해군은 무경험군과 통계적으로 유의한 차이가 없었다. 이상으로 보아 피해아동은 상황에 따른 적응력이 떨어져 적절히 대응하지 못하며, 대인관계를 잘 갖지 못하고 행동이 부산하거나 충동적인 면이 있어 또래관계에서 소외되고, 정서적으로 불안정, 의사소통의 어려움 및 사회기술이 떨어지고 사회적으로 고립되는 인격성향을 보이며, 이러한 특성은 피해전의 특성일수도 있으나, 피해로 인해 생긴 문제일수도 있을 것으로 생각된다. 피해 및 가해아동도 피해아동처럼 적응력이 떨어져 적절히 대응하지 못하고 행동이 부산하거나 충동적인 면이 있으나 사회적 관계를 맺는 기술의 문제나 정신증적인 특성, 자폐증적인 특성을 보이지 않고, 자신이 피해후 갖게된 분노감, 우울, 불안 등을 신체화시키고, 그러한 느낌에서 벗어나기 위해 다른 친구를 가해하는 것으로 생각된다. 이러한 과정을 통하여 피해아동보다 피해후 발생하는 사회적 위축이나 적응상의 문제가 더 적을 것이다. 또한 가해 아동은 인격성향에 있어서 특이소견이 없었던 바 사회문화적, 교육적 측면에서의 접근이 필요할 것으로 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제10권2호
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• pp.145-157
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• 1999

이 논문은 소아청소년 정신병동에 입원한 아동에서 신체적, 정서적 학대와 방임이 동반된 아동을 선별하여 이루어졌다. 입원 아동중 이에 해당하는 아동이 얼마나 되는지 살펴보았으며 학대가 아동의 정서행동에 미치는 영향이 다양하고 가족의 특성과 발달과정에 따른 영향이 서로 상호 작용할 것으로 생각되어 특징적 증상과 발달력, 학대의 특성, 학대자의 특성, 가족역동, 정신병리의 임상적 특징을 알아보았다. 1995년 9월부터 1997년 8월까지 서울대학교 병원 소아청소년 정신과 병동에 입원한 아동 중 주치의의 면담과 병록지를 참조하여 학대와 방임이 뚜렷하다고 판단된 아동, 22명을 대상으로 조사하였다. 1) 아동의 인구학적 특징：성별은 남아가 1：6.3의 비율로 압도적으로 많았고 평균연령은 $11.1{\pm}2.5$세였다. 형제순서는 첫째가 12명(54.5%), 둘째 5명(23%), 셋째는 2명(9%)이었고 독자는 3명(13.5%)이었다. 2) 가족의 특징：사회경제적 상태는 중상 3명(13.5%), 중 9명(41%), 중하 9명(41%), 하 1명(0.5%)이었다. 가족 수는 3인 이하 3명(13.5%), 4∼5인이 17명(77.5%), 6∼7인 2명(9%)이었다. 부가 직업이 있는 경우는 18명(81.8%)이었고 모가 직업이 있는 것은 7명(32%)이었다. 결혼상태는 이혼과 별거가 5명(23.0%), 재혼 2명(9%)이었고 심각한 부부불협화는 19명(86.5%)에서 보였다. 부에서 반사회적 행동은 7명(32%), 알콜 중독은 10명(45.5%)이었다. 모의 알콜남용이 5명(23%)이었고 우울은 17명(77.3%)에서 보였으며 정신과 진료력이 6명(27%)에서 있었다. 3) 학대의 특징：신체적 학대가 18명(81.8%), 신체적 방임과 정서적 방임은 4명(18.2%)이었다. 학대 시작시기는 3세 이전이 15명(54.5%) 3세 이후가 5명(27.5%), 학령기가 1명(5%)이었다. 학대가 부에 의해서만 일어나는 경우는 2명(9%)이었고 모에 의해서만 일어나는 경우는 8명(35.4%)이었으며 부모에 의해 동시에 일어나는 경우는 8명(35.4%)이었다. 배우자 구타가 동반된 것은 7례(27%)에서 였고 배우자 학대의 피해자는 자녀에 대해 신체적 학대나 정서적 학대를 가하고 있었다. 형제자매가 같이 학대를 받고 있는 것은 4명(18.2%)이었다. 4) 학대아동의 일반적 특징 및 발달력：원하던 아이로 태어난 것은 10명(45.5%)이었고 원하지 않는 아이로 태어난 아동이 12명(54.5%)이었다. 학대이전에 언어나 운동발달상의 이상을 보인 아동은 9명(41%)이었으며 공존하는 발달장애가 있는 아동은 모두 15명이었는데 이들 중 학대이전에 뚜렷한 발달지체의 증거가 없었던 경우는 6명(27.5%)이었다. 또 학대이전 과잉운동을 보인 아동은 9명(41%), 키우기 어렵게 지각한 아동이(difficult child) 6명(27.5%)이었다. 뇌파의 이상소견은 5명(23%), 두뇌의 컴퓨터단층촬영이나 핵자기 공명술 이상소견은 4명(18.2%), 벤더-게스탈트검사에서 기질성 뇌장애를 의심할만한 소견은 14명(63.5%)에서 보였다. 지능검사의 결과는 평균이상 IQ는 12명((54.5%), 지능지체 및 경계선 지능은 9명(41.0%)이었다. 5) 주 진단 및 공존진단：주 진단으로는 행실장애가 6명(27.3%), 경계선장애(borderline child) 5명(23.0%), 우울병 4명(18%), 주의력결핍-과잉운동장애 4명(18%), 달리 분류되지 않는 전반적 발달장애 2명(9%), 선택적 함구증 1명(5%)이었다. 모든 대상 아동이 주 진단 이외의 2∼6개 이상의 다양한 공존진단을 보였다. 공존진단에는 주의력결핍-과잉운동장애, 우울병, 경계선지능 및 정신지체, 학습장애, 언어발달장애, 적대적 반항장애, 만성 틱장애, 기능성 유뇨증과 유분증, 달리 분류되지 않는 불안장애, 해리 장애, 기질성 성격장애순이었다. 6) 치료경과：이들 아동의 입원기간은 평균 2.4개월(${\pm}1.5$)이었고. 이들 중 권유에 의한 퇴원은 14명(63.5%), 조기거역퇴원은 6명(27.3%)이었고 증상의 호전을 보인 것은 모두 11명(50%)이었고 변함이 없는 경우도 11명(50%)였다.

• 한국가금학회지
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• 제7권2호
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• pp.54-76
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• 1980

한국에 있어서 양계장의 현재의 기술수준에서 닭의 생산능력이 거의 파악되고 있지 않고 있어 양계산물의 생산량을 추정하거나 특허 증산성이 빠른 닭의 경우 생산조절을 위한 기초 자료가 전무한 상태이다. 따라서 조사자들은 양계협회의 요청에 의거. 현재 양계농가의 관리 기술수준이나 문제점을 위생과 질병을 중심으로 그 실태를 파악하여 문제점의 발굴과 앞으로 생산성을 향상시키는 연구나 지도방향을 설정하고자 본 조사에 착수하였다. 조사 방법은 산란계와 육계를 구분하여 목적에 부합 되도록 용도별로 조사 양식을 작성 야외에서 활동하고 있는 수의사 및 축산 기술전문 요원과 사전에 협의하여 각 지역별로 분담 조사하였으며, 조사 자료 중 검토 후 미흡분은 본성적에서 제외하였다. 조사 대상 및 기간은 산란계의 경우 1976년 3월부터 1978년 7월 사이에 입란한 계군 육계의 경우 1978년 11월부터 1979년 10월 사이에 입추한 계군을 대상으로 사하였으며 조사 지역은 경기도내 6개 지역을 크게 구분하여 총 21개 지역 산란계 41개 양계장 육을 양계장 34개 농장을 대상으로 하였으며 조사 항목별로 조사 성적을 요약하면 다음과 같다. 입지 조건 및 경영 상환에 있어서 산란계의 경우 부업적인 경영이 4.9%로 나머지 95.1% 전업 또는 기업 형태로 육계의 경우에는 부업이 17.7%로 되어 있었다. 한편 양계 경영 년수는 총 경영년수의 경우 산란계 농장이 육계농장 보달. 경영 년수가 높았고 현지에서의 경영 년수도 역시 산란계 농장이 높았다. 입지조건에 있어서는 거주지에 있는 양계장이 10.7%이었고 그 분포는 전, 임야, 답의 순이었으며 지 역 별로는 평지, 구능, 산간지의 순으로 많이 분포되고 있었으며 해안은 한 농장도 얼었다. 양계장의 대지의 소유상환을 보면 자기 소유가 산란양계장은 89.5%. 육용양계장은 70.6% 였으며 양계농장의 평균 소유 면적은 산란계 농장이 5.016평, 육용농장이 1.037평이었다. 계군의 인력 관리는 고용인력에 의존도가 산란계농장이 높아 60%을 상회하고 있었다. 계사의 구조면에서도 아직까지는 위생 시설이 크게 부족한 것으로 나타나고 있다. 특히 타양계장과의 거리에 있어서 1km미만의 거리를 유지하는 농장이 조사대상 농장의 80%나 되고 있으며 100m 이내의 거리를 유지하고 있는 농장이 28%나 되고있어 양계장의 분포 밀도가 크게 높아 전염병의 예방에 있어서 큰 문제점을 내포하고 있다. 계군의 관리상황에 있어서 입추상환. 출하상항, 육성회수 1인당 관리수수 및 관리계군을 조사하였던 바 질병 발생의 기회를 감소시킬 수 있는 관리체계가 거의 되지 않고 있었으며 닭의 품종 및 부화장 선택의 조건에 있어서도 과학적인 근거보다 인간관계 등에 편중되고 있으며 국가에서 실시하고 있는 닭의 능력검정 성적을 활용하고 있지 않는 경향이다. 사료의 급이상황에 있어서도 19.5%가 시판사료 이외의 처방을 요구하고 있다. 위생 및 보건장비의 구비 상환은 완전치 못하였고 소독을 전혀 실시하지 않는 양계장도 다소 있었다. 소독약의 이용량도 높은 편이 아니었다. 백신접종에 있어서 산란계의 경우 ND와 계두백신을 97.6%이용하고 있으나 육계의 경우 ND 백신은 43.6%, 계두의 경우 5.1%만 이용하고 있어 백신의 황용에 있어서 육계의 경우 아주 저조하였다. 백신 효과에 대한 신뢰도에 있어서는 85.3% 이상이 효과가 있다고 응답하였으며 백신의 선택에 있어서는 특성 제품을 요구하는 율이 26.7%나 되고 있다. 그리고 백신접종의 시술에 있어서 수의사에 의뢰하는 예는 불과 4.9%-2.7%였다. ND의 기초면역시 2회이하 접종하는 농장이 17-32.7%나 되고 있으며 (60일령까지) 성계의 보완접종은 4개월마다 실시하는 농장이 14.6%나 되고 있다. 투약상황에 있어서 투약 목적이 질병의 예방목적으로 하는 농장이 74.9%이었으며 프로그램에 의해서 실시하는 농장은 26.8% 월 평균 1개 농장당200,000원 이상 지출하는 농장이 32.0%로 가장 높았다. 약의 선택에 있어서 주관에 의해서 선택하는 경향이 가장 높았으며 수의사의 처방에 의한 것이 33.3%이었다. 약의 효과에 있어 서 자신 있게 효과를 신임하는 농장이 57 3%이었다. 닭 질병 발생시 진단의 의뢰는 가축병원이 49.3%, 직접 부검이 26.7%, 외판원, 전문기관 등의 순으로 의뢰하고 있으며 진단에 있어서 만족감을 갖는 농장은 69.4%이었다. 양계장에서의 질병 발생빈도를 부로일러와 산란계로 구분. 일령별로 조사분류 하였으며 닭의 용도별, 일령간의 질병 발생의 빈도는 가기 특이하게 나타나고 있었다. 생산능력에 있어서 산란계의 경우 육추율이 90.5% 육성율이 98.9%, 성계 및 육계의 생존율은 각각 75.2%, 92.2%이었으며 도태일령은 평균 533.3일이었다. 산란지수는 232.7개이었으며 사료 요구율은 산란계와 육계가 각각 3.30, 2.48로 예상보다는 높았으나 아직 생산 능력을 외국과 비교하였을 경우 개선의 여지가 크게 남아 있음을 본 조사를 통해서 알 수 있었다.

• Radiation Oncology Journal
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• 제16권3호
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• pp.291-301
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• 1998

목적 : 국한성 병기 소세포폐암으로 복합 화학요법과 방사선치료를 받은 환자들에서 통상적 방사선치료와 다분할 방사선치료 간의 종양 관해율, 생존율, 재발율 및 부작용에 대해 비교분석하고자 하였다. 대상 및 방법 : 1989년 11월부터 1996년 12월까지 충남대학교 병원 치료방사선과에서 국한성병기 소세포폐암으로 치료받았던 78명 환자 중 고식적 방사선치료 및 재발성 병변으로 치료받았던 10명을 제외한 68명을 대상으로 후향성 분석을 하였다. 대상환자 중 통상적 방사선치료군(A군)은 26명, 다분할 방사선치료군 (B군)은 42명 이었다. 전체 환자의 연령, 성별 및 ECOG 활동지수는 각각 32-75세 (중앙값 58세), 남자 58명 여자 10명, ECOG 0-1이 58명 2 이상이 10명 이었으며 두군 간에 유사한 분포를 보였다. 방사선치료로서 A군은 총 조사선량 5040-6940 cGy (중앙값 5040 cGy), 180 cGy/fx 로 치료하였고 B군은 총 조사선량 4320-5100 cGy (중앙값 4560 cGy)으로 29명 (69$\%$)은 120 cGy/fx 로, 13명 (31$\%$)은 150 cGy/fx 로 1일 2회 조사하였다. 화학요법은 전체 68명 중 65명에서 VPP (cisplatin 60 mg/$m^2$, etoposide 100 mg/$m^2$) 요법과 CAV (cytoxan 1000 mg/$m^2$, adriamycin 40 mg/$m^2$, vincristine 1 mg/$m^2$) 요법을 교대로 시행하였으며, 화학요법 횟수는 A군 3-10회 (중앙값 6회), B군은 1-11회 (중앙값 6회) 시행하였다. 화학요법 시기는 A군에서 23명이 연속 화학요법을, B군에서는 39명이 동시 화학요법을 시행하였다. 예방적 전뇌조사는 두군 모두에서 완전관해 후 시행하였는데 A군 8명, B군 16명에서 조사선량 2500 cGy/10fx 로 조사하였다. 추적기간은 2-99개월 (중앙값 14개월)였다. 결과 : 종양 관해는 완전관해율, 부분관해율이 각각 A군 35$\%$ (9/26), 54$\%$ (14/26), B군 43$\%$ (18/42), 55$\%$ (23/42)(p=0.119) 였다. 중앙생존기간 및 2년 생존율은 전체환자에서 15개월, 26.8$\%$였고, A군 17개월, 26.9$\%$, B군 15개월, 28$\%$ 0=0.51)였다. 전체환자 중 완전관해 및 부분관해 환자의 2년 생존율은 각각, 35$\%$ 와 24.2$\%$ (p=0.05)였다. 실패양상으로 두 군간에 국소재발 및 원격전이의 통계적인 차이는 없었다 (p=0.125, 0.335). 방사선치료중 발생한 급성합병증으로 RTOG criteria상 중등도 이상의 식도염 및 백혈구 감소가 B 군에서 더 높게 나타났다 (p=0.028, 0.003). 결론 : 국한성 병기 소세포폐암의 복합 화학요법과 방사선치료시 종양의 부분관해 이상의 반응율이 연속화학요법을 받은 통상적 방사선 치료군과 동시화학요법을 받은 다분할 방사선 치료군 모두에서 높게 나타났다. 그러나 두 군간의 생존율에는 통계적인 차이를 보이지 않았다. 급성합병증으로서 식도염과 백혈구 감소가 동시화학요법을 받은 다분할 방사선치료군에서 더 높게났지만, 국한성 병기 소세포폐암에서 동시화학요법과 다분할 방사선치료가 적절한 치료의 한 방법이 될 수 있을 것으로 사료된다. 그러나 국한성 병기 소세포폐암에서 다분할 방사선치료의 장점을 밝히기 위하여 좀더 많은 대상환자와 추적관찰이 필요할 것으로 사료된다.

• 대한방사선기술학회지:방사선기술과학
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• 제38권1호
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• pp.23-30
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• 2015

양전자 방출핵종은 511 keV의 감마선을 방출하기 때문에 기존 140 keV의 99mTc에 비해 종사자의 방사선 피폭의 증가로 피폭선량 저감을 위한 노력이 요구된다. 본 연구는 환자에게로부터 일정거리에 따른 선량률 변화를 확인하고 차폐를 이용하여 외부선량률의 변화를 알아보았으며 환자 주변의 외부선량 분포에 대한 영 향을 분석하여 방사선 종사자의 피폭 관리에 도움이 되고자 하였다. 10 명의 환자를 대상으로 하였으며 평균연령은 $47.7{\pm}6.6$ 세였다. 환자의 키는 평균 $165.5{\pm}3.8cm$, 몸 무게 평균은 $65.9{\pm}1.4kg$으로 비슷한 몸무게의 환자를 대상으로 하였다. 머리, 가슴, 복부, 무릎, 발끝 쪽의 위치에서 10 cm, 50 cm, 100 cm, 150 cm, 200 cm 위치에서 측정하였고 측정 후에 즉시 이동형 방사선 차폐체을 설치한 후 머리와 가슴, 복부 부분에서 100 cm, 150 cm, 200 cm 거리에서 선량률을 측정하였다. 거리에 따른 선량률 변화와 차폐 전, 후의 투과율을 구하였다. 평균 10 cm 거리에서는 머리 부분이 $105.40{\mu}Sv/h$로 가장 높게 나타났으며 발 부분에서 $15.85{\mu}Sv/h$로 가장 낮게 나타났다. 200 cm 거리에서는 머리, 가슴, 복부 부분에서 비슷한 선량률이 나타났다. 머리 부분에 서 차폐 전 100 cm에서 $9.56{\mu}Sv/h$, 150 cm에서 $5.23{\mu}Sv/h$, 200 cm에서 $3.40{\mu}Sv/h$로 나타났으며 차폐 후에는 100 cm, 150 cm, 200 cm 에서 각각 $2.24{\mu}Sv/h$, $1.67{\mu}Sv/h$, $1.27{\mu}Sv/h$로 측정되었다. 가슴 부분에 서 차폐 전 100 cm에서 $8.54{\mu}Sv/h$, 150 cm에서 $4.90{\mu}Sv/h$, 200 cm에서 $3.44{\mu}Sv/h$로 나타났으며 차폐 후에는 100 cm, 150 cm, 200 cm 에서 각각 $2.27{\mu}Sv/h$, $1.34{\mu}Sv/h$, $1.13{\mu}Sv/h$로 측정되었다. 복부 부분에 서 차폐 전 100 cm에서 $9.83{\mu}Sv/h$, 150 cm에서 $5.15{\mu}Sv/h$, 200 cm에서 $3.18{\mu}Sv/h$로 나타났으며 차폐 후에는 100 cm, 150 cm, 200 cm 에서 각각 $2.60{\mu}Sv/h$, $1.75{\mu}Sv/h$, $1.23{\mu}Sv/h$로 측정되었다. 투과율은 거리에 따라 증가함을 알 수 있었다. 거리가 멀어질수록 선량율이 낮아지는 것을 확인할 수 있었으며 차폐를 하였을 경우 차폐를 하지 않았을 때보다 1 / 4 정도 더 낮아지는 것을 확인할 수 있었다. 검사를 진행하는 근무자는 환자와의 거리를 멀리 할 수 없기 때문에 방사선 피폭이 증가할 수밖에 없다. 따라서 적절한 차폐를 한다면 방사선 종사자의 방사선 피폭을 줄 일 수 있을 것이다.

• 대한방사선기술학회지:방사선기술과학
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• 제6권1호
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• pp.131-181
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• 1983

After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

• Radiation Oncology Journal
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• 제13권4호
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• pp.359-368
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• 1995

목적 : 자궁경부암환자에서 근치적 목적으로 방사선치료를 외부조사와 강내조사를 시행한 환자의 실패양상과 생존율을 관찰하고 예후인자를 분석하기 위하여 본 연구를 시도하였다. 방법 : 1982년 3월 부터 1990년 5월 까지 8년간 자궁경부암으로 진단받고 이대부속병원 치료방사선과에서 방사선치료를 시행한 환자 280예 중 근치목적의 방사선치료로서 외부조사와 강내조사를 완료한 환자 114예를 대상으로 후향적 분석을 하였다. 연령분포는 30세에서 77세 까지로 중앙값은 53세이었다. FIGO에 의한 병기분포는 IB 19예($16.7{\%}$), IIA 23예($20.2{\%}$), IIB 42예($36.8{\%}$), IIIA 12예($10.5{\%}$), IIIB 18예($15.8{\%}$)이었다. 병리조직학적소견은 112예가 편평상피암이었고 2예는 선암이었다. 방사선치료방법으로 외부조사는 6MV 선형가속기(6MV,NEC 1000X)를 사용하여 전 골반강에 40-54 Gy를 조사하였으며, 강내조사는 Cs-137 밀봉선원으로 Fletcher-Suit applicator를 사용하여 1회 내지 2회 시행하여 point A에 40-42 Gy를 조사하여 point A의 총 방사선 선량은 병기 IB-IIA는 80-90 Gy(중앙값: 8580 cGy)로, IIB이상은 85-100 Gy(중앙값: 8850 cGy)로 하였다. 추적기간은 1개월에서 85개월로서 중앙값은 30개월이었다. 결과 : 국소실패만 보인 경우는 20예로 전체환자의 $17.5{\%}$이었으며 원격전이와 동반한 국소실패를 보인 경우는 7예($6.1{\%}$)로 전체 국소실패율은 $23.7{\%}$(27/114)이었다. 병기에 따른 국소실패율은 IB에서 $10.5{\%}$, IIA에서 $8.7{\%}$, IIB에서 $23.8{\%}$, IIIA에서 $50.5{\%}$, IIIB에서 $38.9{\%}$이었다. 국소실패부위는 자궁경부가 가장 많아서 전체 국소실패의 $37.5{\%}$(12/32)를 차지하였으며 다음은 자궁막조직으로 $34.3{\%}$(11/32)이었다. 원격전이만 있는 보인 경우는 6예로 전체환자의 $5.3{\%}$를 차지하였다. 원격전이된 부위는 골에 가장 많았으며(4/14), 다음으로 쇄골상관절종(3/14), 간(2/14)의 순으로 나타났다. 재발시기는 치료완료후 3개월에서 50개월이며 중앙값은 15개월이었다. 합병증으로 직장손상이 5예, 방광손상이 9예로서 총 14예($12.3{\%}$)이었다. 전체환자의 5년 생존율은 $70.5{\%}$이었고 병기 IB는 $100{\%}$, IIA는 $76.9{\%}$, IIB는 $77.6{\%}$, IIIA는 $87.5{\%}$, IIIB는 $69.1{\%}$이었다. 5년 무병생존율은 전체환자에서 $53.6{\%}$이었으며, 병기 IB는 $81.3{\%}$, IIA는 $67.9{\%}$, IIB는 $46.8{\%}$, IIIA는 $45.4{\%}$, IIIB는 $34.4{\%}$를 보였다. 무병생존율에 관계되는 예후인자는 다변수 분석에 의하면 performance status(P=0.0063)와 치료반응율(P=0.0026)은 유의성이 있었으나 병기,나이 및 point A의 방사선 선량은 유의성이 없었다. 결론: 자궁경부암환자에서 방사선치료 단독요법에 의한 치료성적은 병기 IB와 IIA는 양호하였으나 IIB이상에서 Point A의 방사선 선량을 90 Gy이상 증가시켜도 국소실패율이 높고 생존율의 향상을 얻을 수 없기 때문에 항암제 혹은 방사선감작제와 병용함으로써 국소제어율을 높이고 원격전이를 감소시키는 방법이 앞으로 연구되어져야 할 과제라고 생각된다.

• Radiation Oncology Journal
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• 제20권3호
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• pp.221-227
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• 2002

목적 : 후향적 분석을 통해 직장암에서 수술 후 화학방사선요법의 치료실패 양상 및 생존율을 확인하고, 그 결과를 다른 연구들과 비교 분석하여 직장암에서의 수술 후 화학방사선요법의 역할을 규명하고자 본 연구를 시행하였다. 대상 및 방법 : 1989년 3월부터 1998년 12월까지 경상대학교병원 치료방사선과에서 직장암으로 수술 후 화학방사선 요법을 받은 119명을 대상으로 후향적 분석을 시행하였다. 모든 환자는 AJCC의 TNM 병기로 분류하여 분석하였다. 연구 대상의 연령 분포는 32세에서 73세까지였으며 중앙값은 56세였다. 수술은 전복부 절제술을 시행받은 경우가 59명, 복부회음 절제술을 시행받은 경우가 60명이었다. T2 12명, T3 96명, 74 11명이었고, N0 43명, N1 53명, N2 23 명이었다. 방사선치료는 6 MV 선형가속기를 이용하여 하루 1.8 Gy씩 주당 9 Gy를 조사하였다. 전 골반 조사량은 $40\~50\;Gy$였으며, 필요에 따라 $5\~6\;Gy$를 소조사야로 추가 조사하였다. 5-FU는 주사로 투여된 경우가 73명, 경구로 투여된 경우가 46명이었다. 추적기간의 기준일은 수술을 시행한 날로 하여 생존자의 경우 최소 추적기간을 3년으로 하였다. 생존율 분석은 Kaplan-Meier 법을 사용하였고 단변량 분석은 log rank test를, 다변량 분석은 Cox regression hazard model을 사용하였다. 결과 : 전체 대상 중 40명이 치료에 실패하여 치료 실패율은 $33.7\%$였다. 국소 단독 실패가 9명$(7.6\%)$, 원격 단독 실패가 24명$(20.2\%)$, 국소 및 원격 실패가 7명$(5.9\%)$으로서, 국소 실패율은 $13.5\%$, 원격 실패율은 $26.1\%$였다. 국소 실패 부위는 골반내 장기가 가장 많았고, 연결부위, 골반 림프절 순이었다. 회음부에서 실패된 경우는 없었다. 원격전이 부위는 간과 폐가 가장 많았다. 전체 5년 생존율 및 무병생존율은 각각 $56.2\%,\;53.3\%$였고, 생존기간의 평균값은 64.8개월, 중앙값은 74개월이었다. T3, T4에서 5년 생존율은 $59.9\%,\;16.8\%$ (p=0.002), 무병 생존율은 $57.2\%,\;25.6\%$였다. N0, N1, N2에서 5년 생존율은 $71.1\%,\;56.7\%,\;31.9\%$, (u=0.0008), 무병생존율은 $68.2\%,\;52.6\%,\;30.1\%$ (p=0.0006)였다. 병기 II, III에서의 5년 생존율은 $71.1\%,\;49.1\%$ (p=0.02), 무병 생존율은 $68.1\%,\;45.8\%$ (p=0.01)였다. 다변량 분석에서 5년 생존율에 영향을 미치는 유의한 인자는 T, N 병기였고, 5년 무병생존율에 영향을 미치는 유의한 인자는 T, N 병기 및 수술 전 CEA 값이었다. 15명$(12.6\%)$에서 수술이 요구되는 장합병증이 발생하였다. 결론 : 수술 후 화학방사선요법은 국소 진행된 직장암에서 국소제어를 위한 효과적인 방법임이 확인되었으나 원격 실패에 대한 효과는 미약하였다. 향후 국소 진행된 직장암의 생존율을 향상시키기 위해서는 원격실패를 낮추고 림프절 전이가 있는 직장암의 국소제어율을 높일 수 있는 치료방법이 개발되어야 할 것으로 사료된다.

• 한국우주과학회:학술대회논문집(한국우주과학회보)
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• 한국우주과학회 1993년도 한국우주과학회보 제2권2호
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• pp.17-17
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• 1993

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.

• 대한의용생체공학회:의공학회지
• /
• 제6권2호
• /
• pp.1-8
• /
• 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.