대형오피스 빌딩 혼합공조(시스템에어컨+중앙공조) 적용사례

서경진(Kyeong-Jin Seo),정기호(Ki-Ho Jung) 대한설비공학회 2004 대한설비공학회 학술발표대회논문집 Vol.2004 No.-

CT colonography 에서 보조 cap을 장착한 catheter의 유용성에 관한 연구

서경진(Kyeong Jin Seo),진은정(Eun Jung Jin),임승현(Seung Hyeon Lim),조영호(Yeong Ho Joh),김영남(Yeong Nam Kim) 대한CT영상기술학회 2015 대한CT영상기술학회지 Vol.17 No.1

Purpose : CT Colonography delivers an accurate diagnosis when the colon is sufficiently expanded, but causes problems in the examination by the leakage of gas when CO2 gas is injected into the anus.The catheter balloon used in the examination is possible to prevent the leakage, but it is not enough for patients with abnormal anal sphincter function causing gas leakage and increase of repeats and patients dose. Therefore, This purpose of our study was to minimize the anus gas leakage through rectal Manometry test and the use of Catheter equipped with an auxiliary cap so that our study examine whether the examination time can be shortened, number of repeats can be reduced and the patient does can be deducted. Materials and methods : For this study, We used Somatom Sensation 16 MDCT(Siemens, Erlangen, Germany) and Automatic CO2 Colon Insufflator(EZEM, New York, USA) with 20 Fr Foley Catheter(2-way standard,30 mL/cc balloon) to inject CO2 gas. The auxiliary cap was inserted at the intervals of 1.5 cm at the location of balloon of the catheter using a fill cap of a 1,000 mL dispensing bottle used by our own hospital. At the hospital from January 13 to 2014 through April 30, 2013, Among The hospital in patients scheduled toundergo surgeries for rectal & sigmoid colon cancers, 110 patients above the age of 60 who completed both Rectal Manometry test which are the objective testing of anal sphincter function and CTColonography test were chosen as the study objects. The CTC test method is a dual testing of prone and supine where testing time differences between the first and the last topogram are compared and the number of repeats is analyzed to differentiate between cases of the auxiliary cap use and non-use according to three categories of anal sphincter normality, findings of bowel obstruction and Buscopan injection. Results : When an auxiliary cap was not used and it was used, In the case of abnormal sphincters, the testing time was 4 minutes when an auxiliary cap was not used and 2.2 minutes when it was used. In the case of findings of bowel obstruction, the testing time was 6 minutes and 4 minute. In the case of absence of Buscopan, the testing time was 4.25 minutes and 2.2 minutes and shortened the testing time to 45%, 33% and 48% respectively in each category when an auxiliary cap was used and All the statistics revealed to be relevant. In the case of abnormal anal sphincter, the number of repeats was from 0.38 times to 0.2 times. In the case of finding of bowel obstruction, it was from one time to 0.44 times. In the absence of Buscopan, the number of repeats was from 0.6 times to 0.4 times. The number of repeats dropped by 47%, 56% and 33% respectively in each category when an auxiliary cap was used. Conclusions : The use of catheter equipped with an auxiliary cap in CTC examination resulted in shortening examination time and the number of repeats. This facilitated an expansion of anal sphincter not only in healthy patients but also in patients with abnormal anal sphincter and findings of bowel obstruction to improve the quality of images, reduce patient dose and failure rate of tests.Especially, it can produce great effects in patients with anorectal surgery patients who are known to lose 90% of anal function, therefore the procedure is likely to produce even better images which is highly valuable clinically when it is applied to such patients. 목적 : CT colonography는 대장이 충분히 팽창되어야 정확한 진단이 가능하지만, 항문에 CO2 gas 주입 시 gas 유출이 발생하여 검사에 지장을 준다. 검사에 사용되는 catheter balloon은 gas 유출 방지가 가능하지만 항문 괄약근 기능이 비정상인 환자에게선 gas가 유출되는 경우 많고 이에 따른 재촬영과 환자 선량 증가가 발생한다. 이에 본 연구는 Manometry 검사와 보조 cap을 장착한 catheter를 사용하여 gas 유출을 최소화하여 검사 시간 및 재촬영을 감소하여 환자 선량을 줄일 수 있는지 알아보고자 한다. 대상 및 방법 : 본 연구를 위해 Somatom Sensation 16 MDCT(Siemens, Erlangen, Germany) 장비와 CO2 gas 주입을 위한 Automatic CO2 Colon Insufflator (EZEM, New York, USA), 20 Fr Foley Catheter(30 cc balloon)를 사용하고, 보조 Cap은 본원에서 사용하는 1,000 mL 투약 병의 주입마개를 이용하여 Catheter의 balloon 부위에서 1.5 cm 정도 간격을 두고 끼워서 사용하였다. 2014년 1월 13일부터 2014년 4월 30일까지 본원에서 Rectal & Sigmoid colon cancer로 수술예정인 입원환자 중 항문 괄약근 기능의 객관적 평가가 가능한 Rectal Manometry 검사와 CT Colonography 검사를 모두 시행한 60세 이상인 환자 110명을 대상으로 하였다. CTC 검사 방법으로 Prone, Supine 두 번의 검사를 하여 처음과 마지막 Topogram의 검사시간 차이와 재 촬영횟수를 측정하여 항문 괄약근 정상 여부, bowel obstruction 여부, Buscopan 사용 여부의 3가지 항목에 따라 보조 cap 사용시와 미 사용시를 구분 지어 분석하였다. 결과: 괄약근이 비정상인 경우 보조 cap을 미 사용시와 사용시 각각 4분, 2.2분이었고, bowel obstruction이 있는 경우 각각 6분, 4분이었으며, Buscopan을 사용하지 않았을 경우는 각각 4.25분, 2.45분으로 각 항목별로 45%, 33%, 48% 모두 보조cap을 사용시에 검사 시간이 단축되었고, 통계적으로 유의한 것으로 나타났다. 재촬영 횟수는 괄약근이 비정상인 경우 보조 cap을 미 사용시와 사용시 각각 0.38회, 0.2회였고, bowel obstruction이 있는 경우 1회, 0.44회였으며, Buscopan을 사용하지 않았을 경우는 0.6회, 0.4회로 각 항목별로 47%, 56%, 33%모두 보조cap을 사용시에 재촬영 횟수가 감소 한 것으로 나타났다. 결론 : CTC 검사에서 보조 Cap을 장착한 catheter는 검사시간 단축과 재촬영을 감소시킬 수 있었다. 이는 정상인뿐만 아니라 비정상(항문 괄약근, bowel obstruction)환자 에서도 대장 팽창에 큰 도움을 주어 영상의 질 개선과 환자 선량 감소, 검사 실패 확률 감소 등을 가져왔다. 특히 항문ㆍ직장 수술환자는 일반적으로 90% 이상이 항문기능 소실이 있으므로 이들에게 적용할 때 더욱 좋은 영상을 얻을 수 있을 것이며 임상적으로 매우 유용할 것이라 생각된다.

Principal Component Analysis와 Multi-Dimensional Scaling 분석을 이용한 시화공단 시흥천의 수질지표 및 미생물 군집 분포 연구

서경진(Kyeong-Jin Seo),김주미(Ju-Mi Kim),김민정(Min-Jung Kim),김성근(Seong-Keun Kim),이지은(Ji-Eun Lee),김인영(In-Young Kim),조경덕(Kyung-Duk Zoh),고광표(Gwang-Pyo Ko) 한국환경보건학회 2009 한국환경보건학회지 Vol.35 No.6

The water quality of Lake Shihwa had been rapidly deteriorating since 1994 due to wastewater input from the watersheds, limited water circulation and the lack of a wastewater treatment policy. In 2000, the government decided to open the tidal embankment and make a comprehensive management plan to improve the water quality, especially inflowing stream water around Shihwa and Banwol industrial complex. However, the water quality and microbial community have not as yet been fully evaluated. The purpose of this study is to investigate the influent water quality around the industrial area based on chemical and biological analysis, and collected surface water sample from the Siheung Stream, up-stream to down-stream through the industrial complex, Samples were collected in July 2009. The results show that the downstream site near the industrial complex had higher concentrations of heavy metals (Cu, Mn, Fe, Mg, and Zn) and organic matter than upstream sites. A combination of DGGE (Denaturing Gradient Gel Electrophoresis) gels, lists of K-WQI (Korean Water Quality Index), cluster analysis, MDS (Multi-Dimensional Scaling) and PCA (Principal Component Analysis) has demonstrated clear clustering between Siheung stream 3 and 4 and with a high similarity and detected metal reducing bacteria (Shewanella spp.) and biodegrading bacteria (Acinetobacter spp.). These results suggest that use of both chemical and microbiological marker would be useful to fully evaluate the water quality.

Respiratory motion phantom을 이용한 Flash mode 검사에서 motion artifact 감소로 인한 화질개선과 선량감소에 관한 연구

서경진(Kyeong Jin Seo),유흥준(Heung Joon Yoo),서동수(Dong Soo Suh),이기백(Ki Baek Lee) 대한CT영상기술학회 2012 대한CT영상기술학회지 Vol.14 No.2

목적 Chest CT는 호흡으로 인한 움직임의 영향을 많이 받기 때문에 호흡을 멈추고 검사를 한다. 호흡조절이 힘든 고령환자나 읍급중환자, 3세 이하 sedation이 필요한 소아환자의 CT검사에서 호흡에 의한 motion artifact를 줄여 질 좋은 영상을 얻는다면 더 정확한 진단과 재검사로 인한 불필요한 선량감소를 얻을 수 있다. 본 연구는 Chest CT에 Flash mode를 적용하여 빠른 tube rotation time과 pitch로 motion artifact를 줄여 image quality를 개선하고, 환자 선량을 낮출 수 있는지 알아보고자 한다. 대상 및 방법 CT 장비는 Somatom Definition Flash 128장비(Siemens, Erlangen, Germany)을 사용하였고, 팬텀은 ACR phantom(Model #462, Gamex RMI, USA과 Lung chest phantom(Model RS-330, Fluke Biomedical), 본원 방사선 종양학과에서 자체 제작한 respiratory moving phantom을 사용하였다. Spiral mode 1,1.5 pitch와 Flash mode 1.55, 2, 2.5, 3 pitch를 각각 검사하여 비교 평가하였다. Image quality 측정을 위하여 ACR phantom의 Noise, Uniformity, High contrast resolution의 visible lp/cm, MTF 10%, MTF 50%를 측정하였고, Respiratory motion phantom의 scan range는 성인은 32cm, 소아는 10cm으로 설정하였고, 호흡에 의한 움직임은 4초와 2초로 각각 설정하여 Lung chest phantom을 스캔 후 3명의 방사선사가 영상 평가를 시행하였다. 또한 Scan time과 CTDIvol도 비교하였다. 결과 Spiral과 Flash mode 각각 6가지 pitch실험에서 ACR phantom의 Noise, Uniformity, High contrast resolution visible lp/cm이 모두 허용범위 안에 있었고, MTF 10%와 MTF 50%도 큰 변화가 없었다. 하지만 Lung chest phantom의 정성적 평가에서 Flash mode의 pitch가 높아질수록 beam hardening artifacts가 심해졌다. Nodule 갯수와 선명도 폐실질 병변의 선명도 폐하부와 횡격막 사이 선명도, lung vessel의 선명도, 전체적인 image quality 등 5가지 항목에서 scan range가 32cm일 때 Spiral mode Chest 검사는 5점 만점이었으며, 성인환자의 호흡주기가 4초와 2초일 때 각각 Flash mode 1.55 pitch, 2.5 pitch 이상에서 병변 관찰이 가능하였고, 소아일 때는 Spiral mode 1.5 pitch 이상에서 병변 관찰이 용이하였다. Scan time은 32cm 검사 시 Flash mode의 pitch가 높아질수록 scan time이 짧아졌다. CTDIvol값은 Flash mode에서 19% 선량 감소가 있었다. 결론 호흡조절이 힘든 환자에서 호흡에 의한 motion artifact는 진단에 방해를 준다. ACR과 Lung chest phantom 평가에서 보았듯이 Flash mode를 사용하여 검사하면 image quality를 유지하면서 motion artifact가 줄어든 것을 확인할 수 있었고, CTDIvol이 19% 정도 줄어들어 환자 선량도 감소한 것을 알 수 있었다. 성인환자의 호흡주기가 4초와 2초일 때 모두 Flash 2.5pitch로 검사하는 것이 가장 좋았으며, 소아의 경우는 Flash의 모든 pitch에서 좋은 영상을 얻을 수 있다. Chest CT는 폐질환 진단 시 가치가 매우 뛰어나고 follow up검사가 많기 때문에 Flash mode를 적용한 Chest CT는 임상적으로도 굉장히 유용할 것이라 생각된다. I. Purpose Because irregular breathing has a bad effect on, Chest CT must be conducted in holding patient’s breath. CT exam of elderly patients, acute care patient and pediatric patients below 3 years who are difficult to breath needs to decrease breath holding time. Reducing Motion artifact according to irregular breathing can acquire excellent image quality and decrease unnecessary dose due to reexamination. This study adapts to Flash mode in Chest CT exam. By reducing motion artifact with fast tube rotation time and pitch, we evaluate improvement of image quality and patient’s dose reduction II. Meterial and Methods CT scans were performed with a Somatom Definition Flash 128-slice MDCT (Siemens, Erlangen, Germany), ACR Phantom(Model #462, Gamex RMI, USA), Lung chest phantom(Model RS-330, Fluke Biomedical) and respiratory moving phantom which is made by Department of radiation oncology, Asan Medical Center. Each exam adapting spiral mode(1 and 1.5 pitch) and flash trode(1.55, 2, 2.5 and 3 pitch) was respectively evaluated. Noise, Uniformity, visible lp/cm of High contrast resolution, MTF 10% and MTF 50% were measured for image quality. Scan range of Respiratory motion phantom was 32 cm for adult and 10 cm for child and respiratory range was 4 second and 2 second respectively. Three radiologic technologist assessed image quality and scan time, CTDIvol were compared respectively. III. Result All six measurement items(Noise, Uniformity, visible lp/cm of High contrast resolution, MTF 10% and MTF 50%) using both Spiral and Flash mode were within a permissible range and there were no significant differences in MTF 10% and MTF 50%. But visible assessments of Lung chest phantom images showed a bad effect on images. The higher a pitch was increased, the worse an image were showed because of rising beam hardening artifacts. Nodule figure & visibility, visibility of lesion, resolution between lower margin of lung and diaphragm, lung vessel definition and overall image quality were evaluated. When scan range was 32 cm, Spiral mode chest exam scored five points out of five, which is the highest score recorded. When the respiratory range in adult patients was both 4 and 2 second, lesion observation was possible with Flash mode of 1.55 and 2.5 pitch and in pediatric patients, only Spiral mode over 1.5 pitch can catch lesion. The higher a pitch of Flash mode used 32cm was, the more scan time was decreased. In Flash mode, CTDIvol value was 19% dose reduction. IV. Conclusions Motion artifact of irregular breathing has a bad effect on diagnostic images. Our experiments show that when Flash mode is adapted in exam, this artifacts are remarkably decreased with high image quality. Also, there is 19% dose reduction. When the respiratory range in adult patients was both 4 and 2 second, it was the best to adapt 2.5 pitch of Flash mode. For pediatric patients, we got the best image on all pitch of Flash mode. Chest CT exam is very critical about lung disease as diagnostic image and shows a significant increase because of f/u(follow up) role. Thus, Chest CT using Flash mode is considered to be very useful in diagnostic imaging.

긴급 후송시 좁은 승강기 사용이 가능한 접이식 노인, 장애인용 응급구급 침대개발에 관한 연구

윤종영(Jong Young Yoon),안혜신(Hye Shin Ahn),김홍찬(Hong Chan Kim),서경진(Kyeong Jin Seo) 한국디자인문화학회 2013 한국디자인문화학회지 Vol.19 No.2

Unlike the buildings of the past, the building of a modern city, high-rise buildings in most cases. Apartment has accounted for the proportion of many living space, unlike the past, the use of elevators became a very important factor. Therefore, the situation must be changed in accordance with the method of moving flow line and changed architecture trends. If proper emergency measures can be performed when carrying patient depending on the condition of the patient, it is possible to minimize the emergency patient rather than only move quickly unconditionally, Therefore, it is necessary to apply to emergency evacuation in accordance with the symptoms, Color and user-friendly shapes are for safe evacuation of patients in case of an emergency. The improvement of the quality by the design in consideration of functionality is an important part to be considered unlike before. According to high-rise buildings of the city, the development of proper products is necessary in case of emergency situations. In this study, in order to transfer the patient safely and quickly in the event of an emergency, development of folding bed emergency first aid that can be used in the small elevator are suggested. For this purpose, the characteristics, configuration and definition of emergency medical system are examined through books for reference. In addition, usability of folding emergency bed are analyzed and solutions are suggested. According to those result, design of folding emergency bed is suggested.

서울대학교 건강캠퍼스 조성연구

이성희(Sunghee Lee),김성연(Sung Yeon Kim),김미순(Misoon Kim),김민정(Min Jung Kim),서경진(Kyeong Jin Seo),박영빈(YoungBin park),고광표(GwangPyo Ko) 서울대학교 보건환경연구소 2009 보건학논집 Vol.46 No.1