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고동희(Dong-Hee Ko),이수영(Soo-Young Lee),심학준(Hak-Joon Shim)전필현(Pil-Hyeon Jeon) 대한CT영상기술학회 2021 대한CT영상기술학회지 Vol.23 No.2
초저선량 흉부 CT(ultra low dose chest CT; ULDCT)는 영상 재구성 기술의 발전으로 기존의 저선량 흉부 CT(low dose chest CT; LDCT)보다 낮은 선량을 사용하더라도 적절한 품질의 영상 획득이 가능하다. 최근 인공지능 기반의 영상 재구성 알고리즘인 AiCE(Advanced Intelligent Clear-IQ Engine)가 상용화가 되었다. 본 연구는 ULDCT에 최신 기술인 AiCE를 적용하여 팬텀 실험과 실제 환자 실험을 실시하여 영상 화질 및 방사선 선량을 정량적으로 분석해 보고자 하였다. Lung man 팬텀에 LDCT, ULDCT프로토콜로 검사하고, Noise, SNR, DLP 값을 구해 기존의 영상 재구성 방식과 이미지 품질 차이를 정량적으로 분석했다. 또한 60명의 인원을 30명씩 두 그룹으로 나누어 AiCE가 적용된 LDCT와 ULDCT 프로토콜을 사용해 검사했다. 팬텀 연구에서 방사선량은 49% 감소했고, AiCE가 적용된 ULDCT 영상이 제일 SNR값이 높고 Noise가 적었다. 환자 실험에서 방사선량은 55% 감소했다. AiCE가 적용된 ULDCT 영상은 체적이 두꺼운 upper lobe 부분에서 약 2%의 SNR 저하와 0.5%의 Noise가 증가했다. 적절한 환자의 체적 범위 내에서 선별하여 사용하는 ULDCT는 피폭 위험도를 절반 이하로 낮춰 주고 환자의 불안감을 해소하면서 최적의 영상을 획득하는 좋은 방안이 될 것으로 판단된다. With the development of new image reconstruction techniques, ultra-low-dose chest computed tomography (ULDCT) can acquire adequate image quality even in lower does than conventional low-dose chest CT (LDCT). Recently, advanced intelligent clear-IQ engine (AiCE), an artificial intelligence-based image reconstruction algorithm, has been commercialized in the medical field. In this study, AiCE, a state-of-the-art technology, was applied to ULDCT to reconstruct both phantom and human image. The lungman phantom was examined by using LDCT and ULDCT protocols. The difference in image quality which applied existing and AiCE reconstruction methods was quantitatively analyzed by computing signal to noise ratio (SNR), noise, and dose length product values. Also, under the application of same AiCE reconstruction methods, 30 patients were tested by using LDCT protocols and another 30 patients were tested by using ULDCT protocols.I n the phantom study, the radiation dose of ULDCT was reduced by 49% compared to LDCT and ULDCT images with AiCE exhibited the highest SNR value and the lowest noise. In the patient study, the radiation dose of ULDCT was reduced by 55% compared to LDCT. In ULDCT images of thick upper lobe with AiCE, the SNR increases by about 2% and the noise decreased by 0.5% compared to LDCT. The selective usage of ULDCT within appropriate body mass index range might provide the reduction of exposure risk and the optimal images while relieving patient anxiety.
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작업환경측정 결과 데이터베이스를 활용한 직무노출매트릭스 구축을 위한 공정 표준화
최상준 ( Sangjun Choi ),박주현 ( Ju-hyun Park ),고동희 ( Dong-hee Koh ),박동욱 ( Donguk Park ),김환철 ( Hwan-cheol Kim ),임대성 ( Dae Sung Lim ),성예지 ( Yeji Sung ),고경윤 ( Kyoung Yoon Ko ),임지선 ( Ji Seon Lim ),서회경 ( Hoekye 한국산업보건학회 2023 한국산업보건학회지 Vol.33 No.1
Objectives: The purpose of this study is to standardize the process code of the work environment measurement database (WEMD) for the construction of a job-exposure matrix (JEM). Methods: The standard process code (SPC) was reclassified based on process similarity and drawing upon the code used in the existing K2B. It was supplemented through review by industrial hygiene experts. In addition, an index word database related to SPC was created and used for SPC search. A pilot evaluation project was conducted by experts to evaluate the validity of the newly reclassified standard process code. Results: A total of 70 final SPCs were developed, including 31 processes related to the construction industry. Using the Shiny program, we developed a standard code finder that can be used on the web (https://kscf.shinyapps.io/scf_app/). As a result of the pilot evaluation, it was determined that it was easier to search for standard codes than previous codes, so it was highly utilized. Conclusions: It is expected that JEM construction using industry-process information drawing on WEMD data will be possible using the 70 newly standardized process codes.
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교사의 긍정적 행동지원이 장애학생의 수업시간 문제행동에 미치는 영향
고동희,이소현 한국정서.행동장애아교육학회(구.한국정서학습장애아교육학회) 2003 정서ㆍ행동장애연구 Vol.19 No.2
The purpose of this study was to investigate the effects of positive behavior support to reduce problem behaviors of students with disability in a special school. The multiple probe baseline design across subjects was used. Three students in a special school for severe behavioral problem participated in the program. The study found that there was a significant positive effect of implementing the PBS program on reducing problem behaviors of all three participants. This data contributes to the growing recognition of how positive behavior support of multicomponent intervention can exert significant influences on the problem behavior. In addition, this study shows that positive behavior support is effective for improving the quality of life of participants and their families. Further more, this study brought changes in teacher's understanding and attitude.
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이선웅,고동희,진구원,박동욱,이정탁,송윤희,이상윤 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1
서론: 과민성폐장염의 원인물질로 금속가공유는 외국의 경우 작업장의 집단발병 사례들을 중심으로 많은 보고가 되어 왔으나 우리나라에서는 아직 보고되지 않았으며,저 자들은 금속가공유에 1년간 노출된 근로자에서 발생한 과민성폐장염 1예를 발견하였기에 작업환경측정을 시행한 후 작업관련성을 평가하여 보고하는 바이다. 증례: 64세 남자 환자가 1년간 강관을 절단하는 작업을 한 후 호흡곤란을 주소로 내원하였다 노출력,임상적 소견 및 방사선학적 소견을 토대로 과민성폐장염으로 진단되었다. 작업환경 측정결과 공기 중 금속가공유,엔도 톡신,총 세균 및 곰팡이는 각각 0.531 mg/m³, 6.33 EU/m³ 100 CFU/m³ 및 75 CFU/m³이었고,금속가 공유 내 엔도톡신,총세균 및 곰팡이는 각각 1.5x10⁴EU/mL,4.6x10^(5) CFU/mL 및 1.8×10^(5) CFU/mL이었다. 고찰: 금속가공유 내의 원인항원에 대한 침강항체를 검사하지 못했으나,작업환경 측정결과 금속가공유가 일반적인 허용가능 수준 이상으로 오염되었으며,기존의 과민성폐장염 발생 사례들과 비슷한 수준 또는 그 이상으로 오염되어 있었다. 공기 중 금속가공유 농도 역사 NIOSH의 REL과 ACGIH의 NIC를 초과하고,기존의 사례들에 비해서도 대체적으로 높은 수준 이었다. 금속가공유 이외의 다른 원인에 대한 감별과 기존의 발생사례들과의 노출수준 비교를 통하여,저자들은 환자가 금속가공유에 의한 미생물 항원에 노출되어 과민성폐장염이 발생한 것으로 판단하였다. Introduction: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. Case report: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m³, 6.33 EU/m³, 100 CFU/m₃ and 75 CFU/m³, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5 X 10⁴EU/mL, 4.6 X 10^(5) CFU/mL and 1.8 X 10^(5) CFU/mL, respectively. Discussion: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.
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