• Title/Summary/Keyword: 객관성

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Anterior Cruciate Ligament Reconstruction: Comparison of Bone-Patellar tendon-Bone Grafts with Hamstring Tendon Grafts (자가 슬개건과 자가 슬괵건을 이용한 전방십자인대 재건술의 비교)

  • Choi, Sung-Wook;Oh, In-Suk;Kim, Ryuh-Sup;Kim, Myung-Ku;Bae, Joo-Han;Park, Hae-Bong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.1-6
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    • 2008
  • Purpose: The purpose of this study is to compare the results of the arthroscopic reconstruction of ACL using autologous hamstring tendon and autologous bone-patellar tendon-bone. Materials and Methods: From January, 2000 to December, 2004, 120 patients underwent arthroscopic ACL reconstruction using autologous hamstring tendon(60 cases) and autologous bone-patellar tendon-bone(BPTB)(60 cases). The mean followed up period of hamstring tendon group was 42 months(range $24{\sim}69$ months) and patellar tendon group was 52 months(range $24{\sim}84$ months). At the time of the final follow up, sixty patients in each group were evaluated the results of physical examination, activity level, patients' satisfaction, functional status, and objective anteriror stability using KT-2000 arthrometer. Results: At the time of the final follow up we compared the two groups who had ACL reconstruction using either autologous hamstring tendon or BPTB, and the final results of the Lachman test showed negative, or mildly positive in 85%(51 cases) of the hamstring tendon group and 90%(54 cases) of the BPTB group. Pivot shift test indicated positive in both groups, 8%(5 cases) and 5%(3 cases) respectively and showed no statistically significant difference. The evaluation of the anterior laxity using the KT-2000 arthrometer revealed no significant difference in the hamstring and BPTB groups: differences less than 3 mm compared to the healthy side were 85%(51 cases) and 90%(54 cases)(p>0.05). The Lysholm score improved from a preoperative score of 51 to a postoperative score of 79.1 in the hamstring groups and from 52 to 82.2 in the BPTB groups. According to the IKDC rating system, 87%(52 cases) were normal or near normal in the hamstring group. In the BPTB group, 83%(50 cases) were normal or near normal. The Tegner score for the hamstring groups was 4.8 preoperatively and 7.1 at the final follow up, and the Tegner score for the BPTB groups was 4.5 preoperatively and 7.3 after the last follow-up. The anterior knee pain was found in 7%(4 cases) in the hamstring tendon group and 10%(6 cases) in the patellar tendon group. Conclusion: Arthroscopic ACL reconstruction using both the autologous hamstring tendon and the patellar tendon during their mid term follow up period demonstrated excellent results. However, the final results during their last follow up showed no statistically significant difference between the two groups.

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The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

건설산업경쟁력 강화와 부실방지대책(안)

  • 한국주택협회
    • 주택과사람들
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    • no.54 s.71
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    • pp.185-206
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    • 1996
  • 1.건설제도의 국제화와 경쟁기반 구축 $\bullet$건설산업을 기획$\cdot$설계$\cdot$시공$\cdot$감리$\cdot$사후관리 등 전 분야에 걸쳐 경쟁력 있는 산업으로 육성-기획$\cdot$설계$\cdot$시공$\cdot$감리$\cdot$유지관리 등 건설산업 전반에 관한 기본사항을 법제화-대규모 공사의 경우 발주자를 대신하여 건설공사의 기획$\cdot$설계$\cdot$발주$\cdot$감리$\cdot$시공관리 등 업무의 전부 또는 일부를 종합적으로 조정$\cdot$관리하는 $\lceil$건설사업관리$\rfloor$제도를 도입 $bullet$건설공사 $\lceil$현장실명제$\rfloor$도입을 통한 하도급제도의 정비-전문건설업자로부터 하도급, 위탁, 고용 등의 형태로 공사에 참여하는 현장근로자를 신고 받아 권익을 보호하고 시공책임도 부과하는 $\lceil$현장실명제$\rfloor$도입 $\bullet$공사완성보증제, 손해배상보증제도를 도입하고, 신용상태 $\cdot$시공능력에 따라 보증 요율 등을 차등화 하여 부실업체를 배제 $\bullet$건설공사관련 각종 계약서와 시방서 등 제기준을 정비하여 발주자$\cdot$시공자 등 건설주체간의 역할과 책임을 명확화$\bullet$건설분쟁을 신속하고 객관적으로 조정$\cdot$중재하기 위하여 $\lceil$건설분쟁중재원$\rfloor$으로 확대 개편 2. 건설인력의 육성과 고용안정$\bullet$경쟁력 제고의 관건인 우수인력 확보를 위하여 대학교육 제도의 개선을 포함한 건설 인력 수급대책을 추진 - 대학의 건설관련 학과 정원을 2000년까지 매년 일정규모로 증원하여 고급기술 인력을 배출 현재 50$\%$에 불과한 건설관련 국가기술자격자를 2000년에 70$\%$까지 제고 - 감리 등 전문인력을 양성하고, 선진외국 감리 회사를 활용하여 국내 업계와의 경쟁을 유도 $\bullet$건설현장의 최일선에서 품질을 담당하고 있는 건설기능공의 고용안정과 복지향상을 위한 획기적인 대책을 마련 - 건설기능공의 자긍심과 사회적 책임의식을 고취하기 위해 기능공이 여러 현장을 전전하여 근무하더라도 경력관리, 공제금 등의 합산 관리가 가능하도록 $\lceil$건설 근로자 복지카드$\rfloor$제도를 도입 *$\lceil$건실시연구단$\rfloor$을 구성$\cdot$구체적인 운영방안을 수립 - 건설 업체 실정에 맞는 현장위주의 기능검정제도 도입 $\cdot$자격증이 현장에서 요구되는 기능수준과 숙련도를 제대로 반영할 수 있도록 검정방법을 현장 실기위주로 개선하고 자격검정업무도 건설협회 등의 자격 검정능력을 향상시켜 위탁$\cdot$시행하는 방안을 검토 3. 공사시행기관의 전문성과 책임성 제고 $\bullet$시장이 개방되어 건설공사가 국제적인 관행에 따라 이루어질 것에 대비하여 시행기관에 계약$\cdot$공사관리 등 전문직공무원을 집중 교육하여 양성 $\bullet$ 조달청이 대행하여 공사계약을 하는 경우라도 설계변경은 발주기관이 자체적으로 할 수 있도록 허용 $\bullet$ 기술직 공무원의 기술향상을 위하여 관련 공무원의 확충, 해외연수, 현장교육 강화 등을 지속적으로 추진 $\bullet$ 충분한 사전조사를 거쳐 사업계획을 수립하도록 $\lceil$건설공사 시행절차$\rfloor$를 규정 $\bullet$ 공사기간 3년 이상의 공사에 대하여는 최대한 계속비사업으로 편성토록 계속비제도의 운영을 활성화 4. 건설현장의 품질관리체제 구축 $\bullet$ 현장배쳐플랜트 설치를 확대하여 레미콘의 품질관리를 일원화하고 현장에서 레이콘을 배합하는 건식공법을 채택 - 현장레미콘생산시설(B/P)설치 확대로 콘크리트 하자에 대한 책임한계 일원화 유도 - 레미콘 재료인 골재$\cdot$시멘트$\cdot$물을 공장에서 혼합하여 공급하는 현행 습식배합 대신에 물만을 현장에서 혼합하는 건식 배합방식을 도입 $\bullet$철강재$\cdot$철구조물의 품질을 보증하기 위하여 일정기술을 갖춘 공장에서만 제작토록 하는$\lceil$공장인증제$\rfloor$를 도입 - 제작시설과 품질관리 등을 심사하여 제작공장을 등급화하고 등급에 따라 철강재 등의 제작업무 범위를 차등화 $\bullet$시설물에 대하여도 시공업체가 제작공장을 등급화하고 등급에 따라 철강재 등의 제작업무 범위를 차등화 $\bullet$시설물에 대하여도 시공업체가 사후관리를 일괄 책임질 수 있도록 $\lceil$시공 및 유지관리 일괄계약제도$\rfloor$를 도입 - 대형교량$\cdot$소각로$\cdot$하수처리장 등 유지관리에 전문성이 요구되는 분야부터 시범적으로 도입 $\bullet$건설자재의 표준화$\cdot$정보화사업을 조속히 추진 5. 건설업체에 대한 지원 강화 $\bullet$일부 공공사업자의 경우 관행화되어 있는 대금일부의 어음 또는 채권지급방법을 단계적으로 축소 $\bullet$매월 감독이나 감리원의 기성확인에 의하여 시공자에게 공사대금을 직접 지급토록 하는 등 대금 지급절차를 간소화 6. 민간 건축물에 대한 안전확보 $\bullet$충실한 설계가 이루어지도록 제도를 개선 - 설계도서 작성기준을 제정하고 다중이용시설에 대하여는 건축심의단계에서 구조검토 등 설계심의를 의무화 $\bullet$대형다중이용시설에 대한 감리 강화 - 감리전문회사 수준의 감리체제로 전환하고 감리대가도 공공수준으로 인상하고 적용요율대로 지도$\cdot$감독 강화

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Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.359-371
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    • 2010
  • Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

Quantification of Brain Images Using Korean Standard Templates and Structural and Cytoarchitectonic Probabilistic Maps (한국인 뇌 표준판과 해부학적 및 세포구축학적 확률뇌지도를 이용한 뇌영상 정량화)

  • Lee, Jae-Sung;Lee, Dong-Soo;Kim, Yu-Kyeong;Kim, Jin-Su;Lee, Jong-Min;Koo, Bang-Bon;Kim, Jae-Jin;Kwon, Jun-Soo;Yoo, Tae-Woo;Chang, Ki-Hyun;Kim, Sun-I.;Kang, Hye-Jin;Kang, Eun-Joo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.241-252
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    • 2004
  • Purpose: Population based structural and functional maps of the brain provide effective tools for the analysis and interpretation of complex and individually variable brain data. Brain MRI and PET standard templates and statistical probabilistic maps based on image data of Korean normal volunteers have been developed and probabilistic maps based on cytoarchitectonic data have been introduced. A quantification method using these data was developed for the objective assessment of regional intensity in the brain images. Materials and Methods: Age, gender and ethnic specific anatomical and functional brain templates based on MR and PET images of Korean normal volunteers were developed. Korean structural probabilistic maps for 89 brain regions and cytoarchitectonic probabilistic maps for 13 Brodmann areas were transformed onto the standard templates. Brain FDG PET and SPGR MR images of normal volunteers were spatially normalized onto the template of each modality and gender. Regional uptake of radiotracers in PET and gray matter concentration in MR images were then quantified by averaging (or summing) regional intensities weighted using the probabilistic maps of brain regions. Regionally specific effects of aging on glucose metabolism in cingulate cortex were also examined. Results: Quantification program could generate quantification results for single spatially normalized images per 20 seconds. Glucose metabolism change in cingulate gyrus was regionally specific: ratios of glucose metabolism in the rostral anterior cingulate vs. posterior cingulate and the caudal anterior cingulate vs. posterior cingulate were significantly decreased as the age increased. 'Rostral anterior'/'posterior' was decreased by 3.1% per decade of age ($P<10^{-11}$, r=0.81) and 'caudal anterior'/'posterior' was decreased by 1.7% ($P<10^{-8}$, r=0.72). Conclusion: Ethnic specific standard templates and probabilistic maps and quantification program developed in this study will be useful for the analysis of brain image of Korean people since the difference in shape of the hemispheres and the sulcal pattern of brain relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques.

Consideration on the Satisfaction of Patients and SUV Variation According to Whether or not to Listen to Music after 18F-FDG Injection (PET/CT 검사에서 18F-FDG 투여 후 음악 청취 여부에 따른 SUV변화와 환자의 만족도에 관한 고찰)

  • Park, Suyoung;Yun, Sunhee;Kim, Hwasan;Kim, Hyunki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.37-43
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    • 2013
  • Purpose: PET/CT scan using the SUV (Standardized Uptake Value) of radiopharmaceutical uptake in organs and tissues as an objective indicator makes it possible to analyze physiological and chemical reactions of human organs. This study analyzes the change of the SUV uptake in accordance with the way how PET/CT patients take a rest after the injection of $^{18}F-FDG$ (Fluororo-deoxyglucose). And also subjective satisfaction is assessed listening to music while taking a rest. Materials and Methods: From April 2011 until February 2013, Among the Primary cancer patients who admitted to the Catholic Medical Center (Seoul & Bucheon St. Mary's Hospital) and scanned $^{18}F-FDG$ PET/CT and also received care through the tracking test (mean age $55.61{\pm}12.41$ years, 108 people, 48 men and 60 women) were selected. The patients were divided into two groups. The first group (A: basal study) is requested to take a rest in bed quietly after the injection. However the second one (B: follow up study) is requested to listen to the music while taking a rest. And then SUV analysis was performed respectively. At the end of the scan, ROI (Region Of Interest) were set from the center of the liver (right lobe) and 3 spots of the brain (frontal, temporal, and occipital lobes). And the SUV was calculated. To identify the correlation among those ROIs, paired t-test was performed using SPSS software (Version 12.0K for windows, P>0.05). Also, after the PET/CT scan the satisfaction study was conducted of all the patients. 1:1 questionnaire survey was performed, and that questionnaire was made using the Likert 5-point scale. By utilizing those questionnaires, the analysis about simple frequency, percentage, average, and standard deviation was performed. Results: The SUV change of the 4 designated ROIs in accordance with listening to music was not statistically significant. (Frontal lobe P-value=0.611, Occipital lobe P-value=0.499, Temporal lobe P-value=0.717, Liver P-value=0.334: P-value>0.05) And the satisfaction study indicated that group B was appear to be 0.42 points (5 basis points) higher than group A. It showed that patients are more satisfied in group B than group A. Conclusion: when performing PET/CT scan using $^{18}F-FDG$, listening to music after the injection of the radiopharmaceuticals does not affect the SUV but given the state of the psychological comfort that may increase the patient's satisfaction.

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Low Oxygen CA Storage of 'Fuji' Apples (후지 사과의 저산소 CA저장)

  • Chung, Hun-Sik;Chung, Shin-Kyo;Choi, Jong-Uck
    • Korean Journal of Food Science and Technology
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    • v.31 no.5
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    • pp.1275-1282
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    • 1999
  • The quality changes by storage conditions were examined in order to establish the optimum CA storage conditions of unbagged and bagged 'Fuji' apples. The weight retention rate of apples was higher in CA than air storage, but there was no significant difference among CA conditions. Bagged apples had higher weight than unbagged apples under the same condition. The loss of flesh firmness, titratable acidity and green color of apples was retarded more effectively in 1% $O_2$ than 3% $O_2$ storage, and in $0^{\circ}C$ and 3% $CO_2$ than $2^{\circ}C$ and 1% $CO_2$ with 1% $O_2$ Titratable acidity tended to decrease more rapidly in bagged than unbagged apples. Soluble solid was not affected by storage conditions. Internal browning was developed within 2 months in 1% $O_2$ and 3% $CO_2$ storage, but there was no significant difference according to storage years and bagging treatment. At the sensory evaluation, unbagged apples were rated as higher quality than bagged apples after 8 months storage, and the hardness, juiciness, acidity and overall acceptability of apples stored in 1% $O_2$ were Higher than those in 3% $O_2$ but those of apples stored in 1% $O_2$ were not affected by $CO_2$(1, 3%) and temperature(0,\;$2^{\circ}C)$ differences. Above results suggest that the optimum CA storage condition of 'Fuji' apples is $0^{\circ}C,\;1%\;O_{2}+1%\;CO_2$.

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A Study for the Certified Security Certification in Private Security Industry in Korea (민간경비 자격제도에 관한 연구)

  • Ahn, Hwang-Kwon
    • Korean Security Journal
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    • no.11
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    • pp.159-181
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    • 2006
  • This study is concerned on Why The Certified Security certification is needed and How to control the security quality to get better service to the clients. Theses days are required The Certified Certificate in all the industry. And in this point of view, the certified certificate is a kind of confirmation by an authority to the person who has how much special knowledge and practice in a certain field. Moreover, in the functionalism society the certified certificate system would be very positive effect to the related industry and society as official measurement by an authority. The security is freedom from fear and anxiety. Which means the security can not be operated in isolation from citizen's safe-living expectation, and which is also dealing with valuable human being's life. For getting the better purpose the security industry employees should have more organized special training and education. As my understanding the certified certificate exam system is the confirmation by an authority, the certified certificate is only neutral evidence to get the confidence and credit from the clients. In this point of view the core point is How to control The Certified Certificate by a credied authority.

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Comparisons of 12-Hour and 24-Hour Sustained-Release Theophyllines in the Management of Asthma (천식치료에서 서방형 Theophylline의 1일 1회 제형과 1일 2회 제형의 비교)

  • Lee, Yang-Deok;Park, Seoung-Ju;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.293-299
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    • 2001
  • Background : Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. The development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. Method : A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation($Etheophyl^{(R)}$) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. The patients were subsequently switched to the once-daily preparation($Uniphyl^{(R)}$) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. Results : The mean serum levels of theophylline were $8.18{\pm}1.66\;{\mu}g/ml$ in the $Etheophyl^{(R)}$-treated period and $8.00{\pm}1.75\;{\mu}g/ml$ in the $Uniphyl^{(R)}$-treated period. ln addition, the $FEV_1$ showed $71.40{\pm}7.48$ percent in the $Etheophyl^{(R)}$-treated and $69.18{\pm}9.00$ percent in the $Uniphyl^{(R)}$-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. Conclusion : The results indicated little clinical differences between the two medications. The two drugs are equally effective in controlling asthma over the four weeks of treatment.

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Revision of Failed ACL Reconstruction - Early Result - (전방 십자 인대 재 재건술 단기 추시 결과)

  • Ahn Jin-Hwan;Cho Yong-Jin;Lee Yong-Seuk;Shin Seong-Kee
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.169-175
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    • 2003
  • Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.

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