• 한국정보통신학회논문지
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• 제21권2호
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• pp.450-460
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• 2017

T파는 심장의 심실의 재분극을 나타내는 파라미터로써 부정맥 진단에 있어 매우 중요하다. T 파를 검출하기 위한 기존 연구방법으로는 주파수 분석과 비선형 접근방법 등이 제안되어 왔지만 검출 정확도가 낮다는 문제점이 있다. 이는 T파의 경우 P파와 중복되는 경우가 발생하기 때문이다. 본 연구에서는 QRS 구간을 제거한 후, 이동평균을 통한 P파와 T파의 대상 영역을 추출하여 정확히 T파를 검출하는 알고리즘을 제안한다. 이를 위해 전처리를 통해 잡음이 제거된 심전도 신호에서 Q, R, S를 검출한다. 이후 검출된 QRS 구간을 제거, 이동평균을 통해 4개의 PAC 패턴과 기타부정맥에 대한 판단규칙을 적용하여 P, T파의 대상 영역을 추출하고, 이를 대상으로 RR 간격과 RT 간격의 문턱치를 적용하여 T파를 검출하였다. 제안한 방법의 우수성을 입증하기 위해 MIT-BIH 부정맥 데이터베이스 48개의 레코드를 대상으로 한 T파의 평균 검출율은 95.32%의 성능을 나타내었다.

• 대한치과마취과학회지
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• 제13권1호
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• pp.1-7
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• 2013

Background: Intravenous sedation is effective for dental patients who are anxious. Recently, target-controlled infusion (TCI) has begun to be used widely to administer and titrate propofol and remifentanil during sedation. To investigate the effect and safety of the pharmacologic agents used in anesthetic department, we performed a retrospective study. Methods: Retrospective study of a series of dental procedure under intravenous sedation performed in department of anesthesiology in Dental Hospital of Dankook University was carried out with propofol or propofol/remifentanil between January and August 2011 and January and April 2012. All patients received oxygen by nasal cannula. The average propofol and remifentanil target was 0.5 ${\mu}g/ml$ and 1.0 ng/ml, respectively using a TCI pump. The average peripheral oxygen saturation ($SpO_2$), heart rate, blood pressure, respiratory rate, nasal end-tidal $CO_2$ were recorded at 5-10 minute intervals. The age, gender, weight, procedure and sedation time, type of procedure were also recorded. Results: We included 22 cases of 19 adults (group A) and 6 cases of children (group B). In group A, 4 patients received propofol (group A-P), and 15 patients received propofol with remifentanil (group A-PR). In group B, 6 patients received propofol only. The mean age of group A was 41.1 years old and that of group B was 9.5 years old. No clinically significant complications were noted. There were no case of de-saturation <90%. The median respiratory rate was 13.1 (range 6 to 36) in group A and 19 (range 13 to 25) in group B. The median end tidal $CO_2$ was 36.7 mmHg(range 8 mmHg to 56 mmHg) in group A and 41.7 mmHg (range 30 mmHg to 53 mmHg) in group B. Conclusions: Based on our results, dental sedation using propofol/remifentanil in adult and propofol in children with TCI pump seems to appear as a safe and effective procedure while performing dental procedure.

• 재활간호학회지
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• 제14권2호
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• pp.95-102
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• 2011

Purpose: The purpose of this study was to analyze intervention studies related to Snoezelen (multisensory environment). Methods: Studies related to Snoezelen (multisensory environment) published between 1995 and 2010 in both Korean and International journals were systematically reviewed, and analyzed following guidelines. Based on inclusion criteria, 23 studies including 5 Korean and 18 International articles were selected. Results: Most studies were conducted in various area of research such as medicine, nursing, and occupational therapy. There was no publication related to Snoezelen (multisensory environment) in Korean nursing journals. In terms of target population, more than 65 % of the study subjects were patients with dementia, mental retardation, and learning disability. Intervention was implemented mostly in less than 30 minutes, once a week for 2 to 4 weeks. The effects on behavior, physical, and psychological contexts were assessed as outcome indicators. There was more 'positive' than 'no effect' in self-stimulatory behaviors, problem behaviors, heart rate, pain, mood state, and anxiety, whereas more 'no effect' than 'positive' in blood pressure, respiration, enjoyment, and relaxation. Conclusion: Future studies are needed to develop the protocol and outcome indicators for effective use of this new intervention in Korea.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.497-505
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• 2018

이 연구의 목적은 중증질환자들을 대상으로 민간의료보험 가입자와 미가입자간의 특성을 파악하고, 가입 요인을 분석하기 위함이다. 연구도구는 2015년도 국민건강영양조사 자료를 이용하였으며, SPSS ver 23.0을 사용하였고, 연구 대상자는 19세 이상 중증질환자(암, 심장질환, 뇌혈관질환) 417명을 선정하였다. 분석방법은 민간의료보험 가입 현황과 차이를 파악하기 위해 교차분석을 실시하였고, 민간의료보험 가입에 미치는 요인을 분석하기 위해 이항 로지스틱 회귀분석을 실시하였다. 분석 결과 사회 인구학적 특성에서는 성별, 거주지, 혼인상태와 관계없이 나이가 젊을수록 높았다. 그리고, 사회 경제적 상태에서는 교육수준과 관계없이 가구소득이 높을수록, 의료급여대상자에 비하여 건강보험대상자의 가입률이 높았다. 건강행태에서는 주관적 건강 인식 및 걷기 실천과 무관하게 활동제한이 있는 집단의 민간의료보험 가입률이 낮았으며, 설명력은 51.7%이었다. 그러므로, 중증질환자 중 민간의료보험에 가입하지 못한 집단을 선별하여 생활환경 개선 및 지방자치단체의 지원을 촉구해야 할 것이다. 또한, 사회적 취약계층 및 건강행태에 제한 있는 집단을 대상으로 중증질환 예방을 위한 정부의 보건교육 또는 프로그램 제공 등 다양한 보건정책을 고려해야 할 것이다.

• 대한의생명과학회지
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• 제6권4호
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• pp.245-251
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• 2000

Cyclohexane에 의한 생체장기의 독성을 검토할 목적으로 흰쥐에 체중 kg당 1.56 g의 cyclohexane을 복강으로 1일 1회 2일 간격으로 4회 투여한 다음 24시간 후에 처치하여 각 장기 (간, 신장, 비장, 심장, 소장, 위 및 폐)의 체중 당 장기무게 (%)와 조직세포중 glucose-6-phosphatase (G6Pase) 활성변동을 측정한 결과, 실험군의 체중 당 폐무게가 대조군에 비하여 현저하게 증가 (p<0.001)하였고 이와는 반대로 G6Pase 활성은 유의한 (p<0.001) 감소를 나타내었다. 그러나 폐를 제외한 장기에서는 별다른 차이를 볼 수 없었다. 이러한 결과는 cyclohexane이 주로 폐조직에 독작용을 야기시킨다는 것을 시사해 주고 있으며, 폐조직에서 malondialdehyde 함량이 대조군에 비하여 유의하게 (p<0.05) 증가된 것이 이를 뒷받침 해 주고 있다. 한편, cytochrome P450에 의해 나타나는 aniline hydroxylase 활성은 폐조직이 간조직에 비하여 대단히 낮았으며, alcohol dehydrogenase (ADH) 활성 역시 간조직 보다 현저하게 낮게 나타났다. 그리고 cyclohexane 투여로 인하여 ADH 활성은 간 및 폐조직 모두에서 증가하였으나 간조직에서 더욱 민감한 반응을 나타내었다. 이상 실험결과를 종합해 볼 때, cyclohexane은 폐조직에 주로 독성을 나타내며 이는 간조직에서 대사된 cyclohexane의 독성 중간대사산물인 cyclohexanone이 혈류를 통해 폐조직에 분포되어 나타난 결과로 사료된다.

• 해양환경안전학회지
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• 제26권6호
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• pp.644-655
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• 2020

본 연구는 항해사가 근접상황에서 심리적 충돌의 두려움으로 당황하여 규정된 충돌 회피조치를 수행하지 못하는 인적오류 상황을 연구하였다. 연구 목적은 선박 간 근접상황에서 항해사의 인적특성 요인인 승선경력, 면허등급, 연령요인이 충돌위험도에 미치는 영향을 규명하는 것이다. 본선과 상대선박 간 네 가지 대표적인 근접상황의 충돌침로에서 항해사가 지각한 충돌위험도 값을 측정, 정량화된 데이터를 얻기 위하여 시뮬레이터를 이용하여 충돌위험도 측정실험을 설계하고 두 척의 선박이 거리 2.5해리에서 충돌상황까지 상호 10노트의 속도로 접근할 때 본선의 30명의 항해사의 심장박동변이를 측정하여 항해사가 지각한 충돌위험도 측정데이터를 확보하였다. 측정값에 대한 다중회귀분석 결과 항해사의 승선경력과 면허등급 요인은 충돌위험도에 부(-)의 영향을 미쳤고, 연령은 영향을 미치지 않았다. t-검정 결과 승선경력≤4년인 항해사는 승선경력≥5년인 항해사 보다 충돌위험도 값이 유의미하게 높았고 면허등급 요인은 4 ~ 6급 그룹이 2 ~ 3급 그룹보다 충돌위험도 값이 유의미하게 높게 나타났다. 본 연구결과는 충돌위험경보시스템 개발에 적용될 수 있을 것이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권4호
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• pp.195-202
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• 2020

Background: Nasotracheal intubation is the most commonly used method to secure the field of view when performing surgery on the oral cavity or neck. Like orotracheal intubation, nasotracheal intubation uses a laryngoscope. Hemodynamic change occurs due to the stimulation of the sympathetic nervous system. Recently, video laryngoscope with a camera attached to the end of the direct laryngoscope blade has been used to minimize this change. In this study, we investigated the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses during nasotracheal intubation with a video laryngoscope. Methods: Twenty-one patients, aged between 19 and 60 years old, scheduled for elective surgery were included in this study. Anesthesia was induced by slowly injecting propofol. At the same time, remifentanil infusion was initiated at 3.0 ng/ml via target-controlled infusion (TCI). When remifentanil attained the preset Ce, nasotracheal intubation was performed using a video laryngoscope. The patient's blood pressure and heart rate were checked pre-induction, right before and after intubation, and 1 min after intubation. Hemodynamic stability was defined as an increase in systolic blood pressure and heart rate by 20% before and after nasotracheal intubation. The response of each patient determined the Ce of remifentanil for the next patient at an interval of 0.3 ng/ml. Results: The Ce of remifentanil administered ranged from 2.4 to 3.6 ng/ml for the patients evaluated. The estimated optimal effective effect-site concentrations of remifentanil were 3.22 and 4.25 ng/ml, that were associated with a 50% and 95% probability of maintaining hemodynamic stability, respectively. Conclusion: Nasotracheal intubation using a video laryngoscope can be successfully performed in a hemodynamically stable state by using the optimal remifentanil effect-site concentration (Ce₅₀, 3.22 ng/ml; Ce₉₅, 4.25 ng/ml).

• 한국운동역학회지
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• 제31권1호
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• pp.72-78
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• 2021

Objective: The purpose of this study was to investigate relations and effectiveness about mountain climbling exercise with different level of support surfaces by analyzing heart rate and EMG data. A total of 10 male college students with no musculoskeltal disorder were recruited for this study. Method: The biomechanical analysis was performed using heart rate monitor (Polar V800, Polar Electro Oy, Finland), step-box, exercise mat, and EMG device (QEMG8, Laxtha Inc. Korea, sampling frequency = 1,024 Hz, gain = 1,000, input impedance > 1012 Ω, CMRR > 100 dB). In this research, step-box were used to create different surface levels on the upper body (flat surface, 10% of subject's height, 20% of subject's height, and 30% of subject's hight). Based on these different conditions, data was collected by performing mountain climbing exercise during 30 seconds. Subjects were given 5 minutes of break to prevent muscular fatigue after each exercise. For each dependent variable, a one-way analysis of variance with repeated measures was conducted to find significant differences and Bonferroni post-hoc test was performed. Results: The results of this study showed that exercise intensity was reduced statistically as increased surface level on the upper body. Muscle activity of the upper rectus abdominis and biceps femoris for 30% of surface level was significantly higher than the corresponding values for flat surface. However, the opposite was found in the rectus femoris. In general, muscle activity of the lower rectus abdominis, erector spinae, external oblique abdominis, and gluteus maximus increased when surface level increased, but the differences were not significant. Conclusion: As a result, the increase in surface level of the body would change muscle activity of the upper body, indicating that different surface level of the upper body may cause significant effect on particular muscles to be more active during mountain climbing exercise. Based on results of this study, it is suggested to set up an appropriate surface level to target particular muscle to expect an effective training. It is also important to set adequate surface levels to create an effective training condition for preventing exercise injuries.

• Journal of Chest Surgery
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• 제44권3호
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• pp.220-224
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• 2011

Background: We investigated changes in the International Normalized Ratio (INR) and its measurement interval in patients with thromboembolic events who were treated by low intensity anticoagulation therapy after isolated mechanical aortic valve replacement. Materials and Methods: Seventy-seven patients who underwent surgery from June 1990 to September 2006 were enrolled in the study and observed until August 2008. The patients were followed up at 4~8 week intervals and their warfarin (Coumadin)$^{(R)}$ dosage was adjusted aiming for a target range of INR 1.5~2.5. The rate of thromboembolic events was obtained. Changes in the mean INR and INR measurement interval were comparatively analyzed between the normal group (event free group, N=52) who had no anticoagulation-related complications and the thromboembolic group (N=10). Hospital records were reviewed retrospectively. Results: The observation period was 666.75 patient-years. Thromboembolic events occurred in 10 patients. The linearized occurrence rate of thromboembolism was 1.50%/patient-years. Actuarial thromboembolism-free rates were $97.10{\pm}2.02%$ at 5 years, $84.30{\pm}5.22%$ at 10 years, and $67.44{\pm}12.14%$ at 15 years. The percentages of INR within the target range and mean INR were not statistically significantly different for the normal and thromboembolic groups. However, the mean INR during the segmented period just before the events showed a significantly lower level in the thromboembolic group (during a 4 month period: normal group, $1.86{\pm}0.14$ vs. thromboembolic group, $1.50{\pm}0.28$, p<0.001). The mean intervals of INR measurement during the whole observation period showed no significant differences between groups, but in the segmented period just before the events, the interval was significantly longer in thromboembolic group (during a 6 month period: normal group, $49.04{\pm}9.47$ days vs. thromboembolic group, $65.89{\pm}44.88$ days, p<0.01). Conclusion: To prevent the occurrence of thromboembolic events in patients who receive isolated aortic valve replacement and low intensity anticoagulation therapy, we suggest that it would be safe to maintain an INR level above 1.8 and to measure the INR at least every 7~8 weeks.

• 전기학회논문지
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• 제63권9호
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• pp.1286-1293
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• 2014

Typically, studies through the simulation system have been progressed, because the evaluation of the driver's arousal state about the service of a actual train has risk of safety for the driver. When configured event same as the real in simulation system, the ability to cope with an accident situation may be the same each other. But the difference in the state of tension or arousal will occur. In this study, requested to cooperate with the railways in order to escape from these constraints, and the target of the experiment was to real engineer service. I was set about experiment when the train was stopped as safe as possible. As a result, the beta wave of EEG signals that representing complex calculations or anxiety is increased rapidly on the basis of a flag station from at the time of departure. The size of the electrodermal activity signal in response to movement of the body gave a noticeable. In terms of HRV, if the train approach a flag station gradually and the R-R interval is narrowed. So that the driver can be estimated as arousal state. In accordance with this study, if the quantitative standard of arousal state be based on the driver's biosignals will provide, it will be able to take advantage of development the system that would prevent train accidents caused by human error.