Does Sedation Affect Examination of Esophagogastric Junction during Upper Endoscopy?

이현직,이상길,김번,김동욱,박준철,신성관,이용찬 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.6

Purpose: During sedated esophagogastroduodenoscopy (EGD), patients may not be able to perform inspiration, which is necessaryto examine the esophagogastric junction. Therefore sedation may affect diagnosis of gastroesophageal reflux-related findings. The aim of our study was to investigate the effect of sedation on diagnosis of gastroesophageal reflux-related findings during EGD. Materials and Methods: This retrospective study evaluated 28914 patients older than 20 years who underwent EGD at our institutionbetween January 2011 and December 2011. Ultimately, 1546 patients indicated for EGD for health check-up and symptom evaluation were included. Results: There were 18546 patients who had diagnostic EGD: 10471 patients (56%) by non-sedated EGD and 8075 patients (43%) by sedated EGD. After statistical adjustment for age, sex, and body mass index, minimal change esophagitis, and hiatal hernia were significantly less frequently observed in the sedated EGD group [odds ratio (OR), 0.651; 95% confidence interval (CI), 0.586 to 0.722 and OR, 0.699; 95% CI, 0.564 to 0.866]. Nevertheless, there was no significant difference in other findings at the gastroesophagealjunction, such as reflux esophagitis with Los Angeles classification A, B, C, and D or Barrett’s esophagus, between the two groups. Similarly, there were no differences in early gastric cancer, advanced gastric cancer, and gastric ulcer occurrence. Conclusion: Sedation can impede the detection of minimal change esophagitis and hiatal hernia, but does not influence detectionof reflux esophagitis of definite severity and Barrett’s esophagus.

DIGITAL MAPPING을 위한 최적 공정 개발

이현직 尙志大學校 生産技術硏究所 1997 生産技術論叢 Vol.- No.2

In recent years, the 1:5,000 scale Digital National Basemap(DNB) has been generated under National Geographic Information System(NGIS) Project. The digital national basemap database generated will be the backdrop data for thematic maps, underground facilities maps and so on. The DNB database will be distributed to the government and private sectors in near future so that it should meet the requirements as the basic data. In order to assure the quality of DNB database, the establishment of optimal process and quality assurance process to database was in great need. In this study, we were mainly concerned with developing some program to improve absurb working ability and improving the quality of digital national basemap database in geomatric aspect as well as the processing time due to the amount of digital data generated. As a result of this study, we have produced 9 digital maps on the Boen area by using those program and then compared with workers per mapping of this study, company and NGI(National Geographic Institute.). The workers per mapping in this study are reduced 41.7% and 17% compared with workers of NGI and general methods respectively. Thus it shows that the program developed in this study is very effective in the productive improvement. And, The quality assurance process of DNB database is established and automatic quality assurance program is developed. Also, the program developed in this study is contributed to quality assurance of DNB database as well as economic aspects.

Age-Related Changes in Left Ventricular Torsion as Assessed by 2-Dimensional Ultrasound Speckle Tracking Imaging

이현직,김봉수,김재훈,장희상,배병석,강현재,이봉렬,정병천 대한심장학회 2008 Korean Circulation Journal Vol.38 No.10

Background and Objectives: The newly developed 2-dimensional ultrasound speckle tracking imaging (2D-STI) has enabled researchers to assess the changes of left ventricular (LV) rotation and torsion. The aims of the present study are to establish normal values and to examine the effect of advancing age on left ventricular torsion. Subjects and Methods: We enrolled 182 healthy persons in this study. After examined the standard clinical echocardiographic parameters, we obtained the degree of the LV rotation at the basal and apical levels of the short axis view with using a customized software program EchoPAC, GE. Results: Among the 182 healthy subjects, 109 healthy subjects were finally included (49 males and 60 females) due to the failure of obtaining reliable rotational patterns (feasibility: 59.8%). The basal and apical peak LV rotations during systole were 8.14±3.55 degrees and 8.48±3.70 degrees, respectively. The basal peak LV rotation and peak LV torsion had a tendency to increase with aging (r=0.277, p=0.004 and r=0.253, p=0.008, respectively). All the values of the basal LV rotation during systole tended to increase with aging. The apical LV rotation had no relationship with aging throughout the entire cardiac cycle. Conclusion: 2D-STI was a feasible methodology to measure the LV rotation. The peak LV torsion during systole shows statistically significant augmentation with advancing age, and this is mainly due to the increased basal LV rotation. Background and Objectives: The newly developed 2-dimensional ultrasound speckle tracking imaging (2D-STI) has enabled researchers to assess the changes of left ventricular (LV) rotation and torsion. The aims of the present study are to establish normal values and to examine the effect of advancing age on left ventricular torsion. Subjects and Methods: We enrolled 182 healthy persons in this study. After examined the standard clinical echocardiographic parameters, we obtained the degree of the LV rotation at the basal and apical levels of the short axis view with using a customized software program EchoPAC, GE. Results: Among the 182 healthy subjects, 109 healthy subjects were finally included (49 males and 60 females) due to the failure of obtaining reliable rotational patterns (feasibility: 59.8%). The basal and apical peak LV rotations during systole were 8.14±3.55 degrees and 8.48±3.70 degrees, respectively. The basal peak LV rotation and peak LV torsion had a tendency to increase with aging (r=0.277, p=0.004 and r=0.253, p=0.008, respectively). All the values of the basal LV rotation during systole tended to increase with aging. The apical LV rotation had no relationship with aging throughout the entire cardiac cycle. Conclusion: 2D-STI was a feasible methodology to measure the LV rotation. The peak LV torsion during systole shows statistically significant augmentation with advancing age, and this is mainly due to the increased basal LV rotation.

대학생의 정치사회화에 영향을 미치는 요인

이현직,조아미 한국청소년학회 2017 청소년학연구 Vol.24 No.8

본 연구는 대학생의 정치사회화에 영향을 미치는 요인에 관한 연구이다. 이를 위해서 정치사회화에 대한 종합적인 선행연구를 통해 정치사회화에 영향을 미치는 요인을 추출하고 그룹핑을 통하여 연구모형을 설정하였다. 설정된 연구모형에 기반하여 설문지를 구성하고 서울ㆍ경기지역에 소재한 대학에 재학 중인 남녀 대학생 150명(남학생 66명, 여학생 84명)을 중심으로 설문조사를 실시하여 우선순위 분석(AHP)과 더불어 추출된 요인들이 인구통계학적인 요소에 따라 영향을 받는 수준 차이 분석(t-test, One way ANOVA)을 실시하였다. 연구결과, 대학생들이 정치사회화에 영향을 받는 요소는 미디어, 가족 순이었으며 세부적으로 인터넷과 아버지로부터 가장 많은 영향을 받는 것으로 밝혀졌다. 더불어 본인출생지와 어머니의 출생지에 따라 정치사회화에 대한 영향을 받는 수준의 차이가 나타나는 것을 확인할 수 있었다. 본 연구의 결과는 지금까지의 연구들이 정치사회화에 영향을 미치는 일반적인 여러 요인들을 도출하고 검증하는 수준을 넘어 여러 요인 중에서 실질적으로 가장 높은 영향을 주는 우선순위를 밝혔다는 점에서 연구의 의의를 지닌다고 할 수 있다. This study is regarding the factors influencing university student political socialization. For this, factors influencing political socialization were abstracted through comprehensive literature review and a study model was established through grouping. A survey questionnaire was developed based on the study model and 150 university students in Seoul and Kyunggi area (66 male students and 84 female students) were surveyed. With priority analysis (AHP), t-test and One way ANOVA were executed to analyze difference effects of demographical factors on the abstracted factors. The result says that the factors affecting university students most were media followed by family. In details, they were affected by Internet and father most. Additionally, it was found that there was difference in the level of effects on political socialization according to birth place of the subjects and that of their mothers. This study is differentiated and is meaningful in that it identified the priority making practically the biggest influence on political socialization among various factors beyond other existing studies which stay in the level of abstracting general factors influencing political socialization.

의료정보서비스 접근성 향상을 위한 개방형 플랫폼 구축방안

이현직,김윤호 한국디지털콘텐츠학회 2017 한국디지털콘텐츠학회논문지 Vol.18 No.7

In this paper, we designed the open service platform based on integrated type of individual customized service and intelligent information technology with individual’s complex attributes and requests. First, the data collection phase is proceed quickly and accurately to repeat extraction, transformation and loading. The generated data from extraction-transformation-loading process module is stored in the distributed data system. The data analysis phase is generated a variety of patterns that used the analysis algorithm in the field. The data processing phase is used distributed parallel processing to improve performance. The data providing should operate independently on device-specific management platform. It provides a type of the Open API. 본 논문에서는 개개인의 복합적 속성과 요구를 반영한 통합된 개인 맞춤형 서비스와 지능정보기술을 기반으로 의료서비스 접근성을 향상시킬 수 있는 개방형 서비스플랫폼의 구축방안에 대하여 설계하였다. 먼저, 데이터 수집 및 저장단계는 데이터 추출, 변환, 로딩을 반복하며 신속하고 정확하게 처리한다. ETL 모듈로부터 생성된 데이터는 분산 파일 시스템에 저장한다. 데이터 분석단계는 스토리지에 저장된 과거 의료 데이터들을 기반으로 기계학습과 데이터 마이닝 분야에서 사용되고 있는 분석 알고리즘을 적용하여 다양한 패턴들을 생성한다. 데이터 처리단계에서는 데이터를 신속히 처리해야 하므로 보통 작업을 병렬 및 분산 처리하여 성능을 향상시킨다. 데이터 제공방식은 디바이스별 운영하는 플랫폼에 독립적으로 동작해야 하며, 데이터 전송 시 네트워크 부하가 적고, 다양한 형태의 서비스를 제공하기 위하여 Open API 형태로 제공한다.

갑상샘 결절의 수술 전 진단에서 초음파 유도하 심부 생검 면역 조직화학적 검사의 유용성

이현직,홍종철,이재훈,홍숙희,박헌수 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.9

Background and Objectives The diagnosis of thyroid nodular diseases is critical for clinical management. Because of the histological similarity of follicular patterned thyroid lesions,the differential diagnosis is often difficult to determine, even with permanent sections. For this reason,we assessed the preoperative diagnostic usefulness of immunohistochemical staining for the four potential markers of malignant thyroid nodule, β-galactosil binding lectin (Galectin-3),Hector Battifora Mesothelial cell (HBME-1), cytokeratin-19 (CK-19) and high molecular weight cytokeratin (HMW-CK) in tissues obtained by ultrasound-guided core needle biopsy. Subjects and Method The immunohistochemical expression of Galectin-3, HBME-1, CK-19 and HMW-CK were evaluated in 43 preoperative thyroid lesions obtained to assess their potential as markers in the diagnosis and classification of thyroid malignancy. We compared the preoperative expression of the four markers with the results of postoperative permanent pathology. Results The expression patterns and positive rates of four markers were the variables in 4thyroid lesions; however, all markers were strong in malignant thyroid nodules, especially in papillary carcinoma. There were no significant differences in the expression rates of the four markers between follicular carcinoma and follicular adenoma. The sensitivity of HBME-1 for thyroid malignancy was the highest (86%) among the four markers, but the sensitivity of combinational expression using two markers, especially Galectin-3 or HBME-1 (95%), HBME-1 or HMW-CK (90%), was higher than that of the expression using one marker for thyroid malignancy. Conclusion The four markers were reliable markers for papillary carcinoma. In preoperative differential diagnosis of thyroid nodule, we suggest that the combinational expression using two makers is more useful than a single marker expression. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:564-70

일시적인 횡와 자세와 흉와위 영상에서 폐 불투과도의 상관관계

이현직,정지윤,최우신,이동훈,이영재,장진화,장동우 한국임상수의학회 2015 한국임상수의학회지 Vol.32 No.4

The lung opacity on radiography is influenced by various factors. The physical density of the lung and the attenuation ensured on computed tomography (CT) scans is determined by three components : lung tissue, blood, and air. Temporary right lateral recumbency may responsible for the increase of opacity on ventrodorsal projection view. Thus, our aim is to demonstrate that the effect of right lateral recumbency posture on right lung opacity using radiograph and CT scan. In this study, 62 dogs without clinical or radiologic signs of cardiopulmonary disease are selected. Thorax radiographs per 30 seconds for 2 minutes (30s, 60s, 90s, 120s) were performed for 62 dogs. After discussion of the radiographic findings of lung field by two radiologists and a student at Chungbuk national university veterinary medical center a consensus opinion was recorded. Computed tomography per a minute (1 min, 2 min) for 2 minutes were performed for 2 dogs. Mean x-ray attenuation of lung was measured quantitatively using software at two levels (aortic arch and basal level). Among 62 dogs with radiograph comparison, 9.3% of dogs showed influence by postural effect. However, all 2 dogs with computed tomography comparison, showed influence by postural effect. In conclusion, position dependent changes of lung density in CT exam are not consistent with thoracic radiograph.

Arm-up holder의 보조기구 제작에 따른 유용성 평가

이현직,최병기,심재구,김종식,오동균,박영환 대한방사선치료학회 2002 大韓放射線治療技術學會誌 Vol.14 No.1

I. 목적 : arm-up holder는 흉부 및 복부 질환 치료의 환자고정에 유용하게 사용하고 있으나 손잡이 부분과 어깨가 닿는 부분까지 거리 때문에 동일한 자세를 유지하는데 불편함이 있다. 특히 긴장을 많이 하거나 기력이 없는 환자는 방사선 치료 시 자세의 불안정으로 인하여 치료의 정확성이 떨어질 수 있다. 이에 본원에서는 현재 사용하고 있는 arm-up holder에 팔의 지지를 위한 보조기구를 제작하여 유용성을 평가하였다. II. 대상 및 방법 : 기존의 arm-up holder에 어깨받침대를 부착하여 개선된 arm-up holder를 제작하였다. 실험을 위하여 기존의 arm-up holder를 사용하는 환자그룹과 개선된 arm-up holder를 사용하는 그룹으로 구분하여 자세 변화를 평가하였다. 두 그룹의 환자를 대상으로 모의 치료를 실시한 후 치료실에서 L-gram 을 2회 씩 촬영하여 치료하고자 하는 portal film과 isocenter의 변화를 측정했다. 각 그룹 당 10명씩의 환자를 선정하여 반복 조사하였다. III. 결과 : 개선된 arm-up holder를 사용한 그룹의 isocenter 의 변화는 최대 2mm, 최소 0.5mm 평균 1.2mm 이다. 기존의 arm-up folder를 사용한 그룹과 비교하여 평균변화는 약 2배로 나라났고, 최대 변화는 2.5배의 오차범위가 측정되었다. IV. 결론 : 현재 사용하고 있는 arm-up holder는 흉부 및 복부의 사방향 방사선 치료 시 팔에 의한 방사선 감약을 예방할 수 있는 유용한 고정용구이다. 하지만 팔을 올리고 있는 자세는 환자에게 불편함을 야기 시키며 이로 인한 치료의 정확성을 감소시킬 수 있다. 따라서, 기존의 arm-up holder에 보조기구를 제작하여 사용함으로써 환자의 불편함을 개선하고, set-up 의 안정성과 재현성을 향상시킬 수 있었다.

화상처리기법을 이용한 고해상도 이색 PIV 알고리즘 개발 ( Development of High-Resolution two-color PIV Algorithm using Digital Image Processing Techniques )

이현직,정재우,이기형,이창식 대한기계학회 1997 대한기계학회 춘추학술대회 Vol.- No.-

좌측 악하선에 발생한 상피-근상피암종 1예

이현직,홍종철,나서희,박헌수 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.9

Epithelial myoepithelial carcinoma is a rare tumor with slightly less than one percent of salivary gland neoplasm. Histologically, the carcinomas are characterized by a mixture of trabecular structure with outer myoepithelial cells and inner ductal cells, which are confirmed by electron microscopy and immunohistochemistry. Although this neoplasm exhibits high degree of cellular differentiation histologically, it is classified into low grade carcinoma because of its locally infiltrative,destructive growth pattern, and tendency to metastasize. We report a 45-year-old woman with epithelial-myoepithelial carcinoma arising from a submandubular gland, one of the most unusual locations. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:582-4