• Title/Summary/Keyword: 아기

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Early Result of Surgical Management of the Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (관상동맥-폐동맥 이상 기시증에 대한 수술의 조기 결과)

  • Yoon Yoo Sang;Park Jeong Jun;Yun Tae Jin;Kim Young Hwue;Ko Jae Kon;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.18-27
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    • 2006
  • Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

Exploration and Development in the Janggun Pb-Zn Mine (장군광산(將軍鑛山)의 탐사(探査)와 개발현황(開發現況))

  • Kho, Suck Jin
    • Economic and Environmental Geology
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    • v.20 no.4
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    • pp.289-303
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    • 1987
  • 당(當) 광산(鑛山)은 1936년(年) 금(金), 은(銀) 광종(鑛種)으로 출원(出願)하였다가 1940년(年) 망간을 추가(追加)하여 망간 광산(鑛山)으로 1975년(年)까지 Mn(30~35%) 110,000여(餘)톤을 생산(生産), 국내생산량(國內生産量)의 70%를 점(占)하였고 1976년(年) Mn광상(鑛床) 하부(下部)에 연(鉛), 아연(亞鉛) 유화광(硫化鑛)을 발견(發見), 현재(現在)까지 Pb十Zn=10% 이상(以上) 원광석(原鑛石) 500,000여(餘)톤을 처리(處理), 연정광(鉛精鑛)(Pb : 62%) 37,000여(餘)톤, 아연정광(亞鉛精鑛)(Zn : 46.5%) 37,000여(餘)톤, 유비광정광(硫砒鑛精鑛)(As : 30%) 5,000여(餘)톤을 생산(生産)하였다. 현재(現在) 일처리(日處理) 220톤 선광장(選鑛場)을 일처리(日處理) 400톤 규모(規模)로 증설계획중(增設計劃中)이다. 당(當) 광산(鑛山)에서 현재(現在)까지 시행(施行)한 갱외시추(坑外試錐)는 75개공(個孔) 18,500여(餘)m, 갱내시추(坑內試錐) 750개공(個孔) 40,000여(餘)m 갱도(坑道) 총연장(總延長) 13,000m에 달(達)하며 지표(地表)(623ML)로 부터 수직(垂直) 300m 하부(下部)까지 갱도(坑道)가 개착(開鑿)되어 있다. 당(當) 광산(鑛山)의 지질(地質)은 여러 조사서(調査書)에 의(依)하여 견해(見解) 차이(差異)를 보여주고 있으나 대체(大體)로 다음과 같은 쪽으로 인정되고 있다. 즉(卽) 본지역(本地域) 루층군(累層群)의 층순(層順)을 하위(下位)로 부터 상위(上位)로 향(向)하여 원남층(遠南層)${\rightarrow}$율리통(栗里統)${\rightarrow}$장산규암층(壯山珪岩層)${\rightarrow}$두음리층(斗音里層)${\rightarrow}$장군석회암층(將軍石灰岩層)${\rightarrow}$동수곡층(東水谷層)${\rightarrow}$재산층(才山層)의 순위(順位)로 보며 장산규암층(壯山珪岩層)과 두음리층(斗音里層)을 조선계(朝鮮系)의 양덕통(陽德統)으로, 장군석회암층(將軍石灰岩層)을 대석회암통(大石灰岩統)으로, 동수곡층(東水谷層)과 함탄층(含炭層)인 재산층(才山層)을 평안계(平安系) 지층(地層)으로 대비(對比)한다. 이들은 본지역(本地域) 북(北)쪽에서는 선(先)캠브리아기(紀)의 원남층(遠南層)과 율리통(栗里統)을 불정합(不整合)으로 덮고 남측(南側)에서는 재산층(才山層)과 원남층(遠南層)이 단층접촉(斷層接觸)하고 있다. 이들 지층(地層)의 주향(走向)은 $N60^{\circ}{\sim}80^{\circ}W$, $N60^{\circ}{\sim}80^{\circ}E$이며 경사(傾斜)는 대체(大體)로 $50^{\circ}{\sim}80^{\circ}N$이며 전체적(全體的)으로 역전(逆轉)된 층서(層序)를 보여주는 바 지질구조(地質構造)에 있어서 단사구조(單斜構造)인지 등사(等斜)습곡의 향사(向斜), 또는 등사(等斜)습곡이 배사구조(背斜構造)인지 아직 밝혀지지 않고 있다. 화성암체(火成岩體)는 본지역(本地域) 서측(西側)에 쥬라기(紀) 춘양화강암(春陽花崗岩)이 불규칙(不規則)한 실입(實入) 접촉면(接觸面)을 보여주며 시대미상(時代未詳)(백악기(白堊紀)?)의 거정화강암(巨晶花崗岩), 반화강암(半花崗岩)이 소암주상(小岩株狀)으로 몇 곳 실입(實入)하고 산성(酸性)~중성(中性)의 맥암(脈岩)과 염기성(鹽基性) 안산암질암(安山岩質岩)이 실입(實入)해 있다. 광상(鑛床)은 장군석회암층(將軍石灰岩層)에 배태(胚胎)되어 있는 열수교대(熱水交代) 연(鉛), 아연(亞鉛), 은등(銀等)의 혼합(混合) 유화광상(硫化鑛床)으로 다량(多量)의 Mn분(分)을 수반(隨伴)하며 지표부(地表部)에 Mn광상(鑛床)을 형성(形成)하고 있다. 광상(鑛床)의 형태(形態)는 괴상(塊狀), 각력(角礫)pipe상(狀), 맥상(脈狀)으로 나타난다. 광상(鑛床)의 성인(成因)과 생성시기(生成時期)에 대(對)하여 많은 논란(論難)이 있다. 즉(卽) 열수교대(熱水交代)냐, 접촉교대(接觸交代)냐, 동시퇴적기원(同時堆積起源)이냐, 또는 생성시기(生成時期)가 쥬라기(紀)인지 백악기(白堊紀)인지에 대해 이론(異論)이 있다. 본지역(本地域) 광상(鑛床)은 남본(南本), 100우(右), 북(北), 유비철(硫砒鐵), 동(東), 서(西), 재남(才南), 재동(才東), 110호(號) 등(等)이 지표(地表) Mn로두광화대(露頭鑛化帶)와 관련(關聯) 명명(命名)된 바 전(前)4자(者)는 하부(下部)에서 유화광상(硫化鑛床)이 확인(確認)되었으나 나머지 후자(後者)에서는 아직 하부(下部)에 유화광상(硫化鑛床)이 확인(確認)되지 않고 있으며 남본광상(南本鑛床)으로 부터 남동(南東) 300여(餘)m 지점에 장군석회암층(將軍石灰岩層)과 동수곡층(東水谷層) 경계부(境界部)에 Fe 55~60% 자철광상(磁鐵鑛床)이 확인(確認)된 바 신례미(新禮美) 자철광상(磁鐵鑛床)과 유사성(類似性)이 있는 것 같아 흥미(興味)롭다. 당(當) 광산(鑛山)의 현재(現在)까지의 탐광(探鑛)은 남본광상(南本鑛床) 지표로두(地表露頭)(Mn) 하부(下部)에서 확인(確認)된 연(鉛), 아연(亞鉛), 은(銀) 유화광체(硫化鑛體) 하부(下部)와 전탐(電探)에 의(依)해 확인(確認)된 북광체(北鑛體), 갱도접근중(坑道接近中)에 확인(確認)된 100우광체(右鑛體), 유비철광체(硫砒鐵鑛體) 등(等)의 하부(下部) 탐광(探鑛)을 주(主)로 하고 지표(地表) Mn로두(露頭) 하부(下部)에 대(對)한 시추탐광(試錐探鑛0을 병행(竝行)하고 있으며 시추(試錐)에 의(依)해서 지표(地表)로 부터 790m 하부(下部)(해발(海拔) 200ML)까지 광화대(鑛化帶)가 확인(確認)되었다. 향후(向後) 탐광방침(探鑛方針)을 확고(確固)히 수립(樹立)하기 위(爲)하여는 광상(鑛床)의 성인구명(成因究明)은 물론(勿論) 광상(鑛床)의 배태조건(胚胎條件)에 있어 지질구조규제(地質構造規制)와 화강암(花崗岩)의 실입상(實入狀)과의 관계(關係), 광액(鑛液)의 통로(通路)에 대(對)한 지질구조(地質構造), 모암(母岩)의 화학(化學) 물리적(物理的) 특성(特性)에 대(對)한 연구(硏究) 검토(檢討)가 었어야 하겠다.

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A Study on Practical Curriculum Development of the Education for Love based on the Understanding of Psychoanalytic 'Desire of Subject' (정신분석학적 '욕망의 주체' 이해에 기초한 사랑의 교육 교육과정 개발)

  • Kim, Sun Ah
    • Journal of Christian Education in Korea
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    • v.68
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    • pp.77-112
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    • 2021
  • This study is based on the research of the first year, which is the National Research Foundation of Korea's R&D subject for middle-grade researchers. In this study, the practical curriculum development of the education for love - an according to the psychoanalytic perspectives of F. Dolto(1908-1988) - is suggested as follows. The first is 'the reconstruction of the directions of curriculum and its specific aims in accordance with such directions.' The reconstruction of the directions of curriculum aims at leading our future generation to live as a subject of desire through the mutual-communication of love. The second is 'the reconstruction of the tasks of curriculum and its specific contents in accordance with such tasks.' The reconstruction of the tasks of curriculum pursuit to help our future generation through the converting the education for love into the paradigm of desire of Agape to live as a subject of desire forming a whole personality and practicing the desire of Agape in daily life. as a source of desire. According to these aims, the reconstruction of directions of curriculum are presented as following: firstly, 'curriculum for the mutual-communication between subjects of love' and secondly, 'curriculum for the subject of desire'. The reconstruction of tasks of curriculum are like these: firstly, 'converting the education for love into the paradigm of desire of Agape', and secondly, 'forming a whole personality through the education for love'. Thus, with respect to two specific aims in accordance with the reconstruction of directions are suggested like these: Firstly, 'constructing a subject as a speaking existence' and secondly, 'realizing the subject as the autonomous source of desire'. In the two specific contents in accordance with the reconstruction of tasks are presented as following: Firstly, 'realizing the truth of the desire of Agape'.' Secondly, 'practicing the desire of Agape in daily life.' The third is 'the reconstruction of curriculum by life cycle' are suggested. They include the fetal life, infants and preschool children life, and childhood life. In further study, it is required to contain adolescent period. It will be useful to help them to recover their self-esteem with the experience of true love, especially, out-of-school young generation overcome negative perspectives and prejudice in the society, and challenges to their dreams and future through proper utilization of the study outcome. The outcome of this study, which presented practical curriculum development of the education for love based on the understanding of psychoanalytic 'desire of subject' can be used as basic teaching materials for our future generations. Furthermore, the results can be used as a resource for educating ministers and lay leaders in the religious world to build capabilities to heal their inner side as well as the society that is tainted with various forms of conflict. These include general conflicts, anger, pleasure and addiction, depression and suicide, violence and murder, etc. The study outcome can contribute to the prevention of antisocial incidents against humanity that have recently been occurring in our free-semester system implemented in all middle schools across the country to be operated effectively. For example, it is possible to provide the study results as lecture and teaching materials for 'character camp' (self-examination and self-esteem improvement training) and 'family healing camp' (solution of a communication gap between family members and love communication training), which help students participate in field trip activities and career exploration activities voluntarily, independently, and creatively. Ultimately, it can visibly present the convergent research performance by providing the study outcome as preliminary data for the development of lecture videos and materials including infant care and preschool education, parental education, family consultation education, and holistic healing education. Support from the religious world, including the central government and local governments, are urgently required in order for such educational possibilities to be fulfilled both in the society and the fields of church education and to be actively linked to follow-up studies.

Development and evaluation of Pre-Parenthood Education Program for high school students based on Home Economics subject (고등학생을 위한 가정교과 기반 예비부모교육 프로그램 개발 및 평가)

  • Noh, Heui-Yeon;Cho, Jae Soon;Chae, Jung Hyun
    • Journal of Korean Home Economics Education Association
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    • v.29 no.4
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    • pp.161-193
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    • 2017
  • The purpose of this study was to develop and evaluate pre-parenthood education program(PPEP) based on Home Economics(HE) subject for high school students. The development and evaluation of PPEP based on HE subject in this study followed ADDIE model except implementation through 4 processes such as analysis, design, development, and evaluation. First, program development directions were set in three aspects such as 'general development', 'contents', and 'teaching and learning methods'. Themes of the program are 11 in total such as '1. Parenting, what is being a parent', '2. Choosing your spouse, happy marital relationship, the best gift to your children', '3. Pregnancy and birth, a moving meeting with a new life', '4. Taking care of a new born infant for 24 hours', '5. Taking care of infants, relationship with my lovely baby, attachment', '6. Taking care of young children, my child from another planet', '7. Parents and children in healthy family', '8. Parent-child relationship, wise parents to make effective interaction with their children', '9. Parents safety manager at home,', '10. Practice to take care of infants', and '11. Practice of community nurturing support service development'. In particular, learning activities of the program have major characteristics such as 1) utilization of cases including practice problems related to parenting, 2) community exchange activities utilizing learned knowledge and techniques, 3) actual life project activities utilizing learning contents related with parenting, 4) activities inducing positive changes in current life of high school students, and 5) practice activities for the necessities of life such as food, clothing and shelter supporting development of children. Second, the program was developed according to the design. Teaching-learning plans and materials for 17 classes were developed according to 11 themes. The developed plans include class flow and teacher's reference. It starts with receiving a class-related message from a virtual child at the introduction stage and ended with replying to the message by summarizing contents of the class and making a promise as a parent-to-be. That is the basic frame of class flow. Learning materials included various plans and reports necessary for learning activities and they are prepared in details so that they can be play the role of textbooks in regular curriculum. Third, evaluation of developed program was executed by a 5 point Likert scale survey on 13 HE experts on two aspects of program development process and program development results. In the evaluation of development process, mean value was 4.61 and index of content validity was 97.4%. For development results, mean value was 4.37 and index of content validity was 86.9%. These values showed that validity in the development process and results in this study was highly secured and confirmed that PPEP based on HE was appropriate and valid to enhance parent qualifications of high school learners.

The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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Anatomical Studies on Root Formation in Hypocotyl and Epicotyl Cuttings of Woody Plants (임목(林木)의 배축(胚軸) 및 유경삽수발근(幼茎揷穗発根)의 해부학적(解剖学的) 연구(研究))

  • Choi, Man Bong
    • Journal of Korean Society of Forest Science
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    • v.52 no.1
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    • pp.1-30
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    • 1981
  • The origin and development of adventitious roots was studied using hypocotyl and epicotyl cuttings of 34 species, 24 genus of woody plants. These cuttings obtained from young seedlings cultured in vials containing distilled water only. The several characteristics of cuttings materials studied are shown in Table 1. The results are summerized as follows: 1. The circumference shapes of cross-sections of hypocotyl and epicotyl cuttings can be divided into six categories, namely, round, irregular round, ellipse, irregular ellipse, square, and triangle. Species differences within a genus did not show any difference of hypocotyl and epicotyl cross-sections shape, however, a noticeable variation among genus or higher taxa. 2. The arrangements of vascular bundles in the cross-sections of hypocotyls or epicotyls were almost all collateral types and generally showed generic characteristics differing one to the other. However, there were some variations between species within the genus. Six models of vascular bundle arrangement were proposed for all the above speices. 3. The rooting portions of hypocotyl and epicotyl cuttings in this experimental materials can be grouped as follows: (1) Interfascicular parenchyma; (Thuja orientalis. T. orientalis for. sieboldii, Acer microsieboldianum, A. palmatum, A. saccharinum, Cercis chinensis, Lespedeza bicolor, Magnolia obovata, M. sieboldii, Mallotus japonicus, Staphylea bumalda) (2) Cambial and phloem parenchyma: (Chamaecyparis obtusa, C. pisifera, Albizzia julibrissin, Buxus microphylla var. Koreana, Cereis chinensis, Euonymus japonica, Firmiana platanifolia, Lagerstroemia indica, Ligustrum salicinum, L. obtusifolium, Magnolia kobus, M. obovata, Mallotus japonicus, Morus alba, Poncirus trifoliata, Quercus myrsinaefolia, Rosa polyantha, Styrax japonica, Styrax obassia) (3) Primary ray tissues; (Euonymus japonica, Styrax japonica) (4) Leaf traces; (Quercus acutissima, Q. aliena) (5) Cortex parenchyma; (Ailanthus altissima) (6) Callus tissues; (Castanea crenata, Quercus aliena, Q. myrsinaefolia, Q. serrata) 4. As a general tendency throughout the species studied, in hypocotyl cuttings, the adventitious root primordia were originated from the interfascicular parenchyma tissue, however, leaf traces and callus tissues were contributed to the root primordia formation in epicotyl cuttings. The hypocotyl cuttings of Ailanthus altissima exhibited a special performance in the root primordia formation, this means that cortex parenchyma was participated to the origin tissue. And in Firmiana platanifolia, differening from the other most species, the root primordia were formed at the phloem parenchyma adjacent outwardly to xylem tissue of vascular bundle system as shown photo. 48. 5. All the easy-to, or difficult-to root species developed adventitious roots in vials filled with distilled water. In the difficult-to-root species, however, root formations seemed to be delayed because they almost all had selerenchyma or phloem fiber which gave some mechanical hindrance to protrusion of root primordia. On the other hand, in the easy-to-root species they seemed to form them more easily because they did not have the said tissues. The rooting portions between easy-to-root and difficult-to-root species have not clearly been distinguished, and they have multitudinous variations. 6. The species structured with the more vascular bundles in number compared with the less vascular bundles exhibited delayed rooting. In the cuttings preparation, the proximal end of cuttings was closer to root-to-stem transition region, the adventitious root formation showed easier. 7. A different case occured however with the mature stem cuttings, in both the needle-leaved and the broad-leaved species. In the hypocotyl cuttings, parenchymatous tissues sited near the vascular bundles become the most frequent root forming portions in general and relevant distinctions between both species were hardly recognizable. 8. In the epicotyl cuttings, root primordia originated mainly in leaf traces in connection with cambial and phloems or callus tissues itself. In the hypocotyl cuttings, interfascicular parenchyma was the most frequent portion of the root primordia formation. The portions of root primordia had more connection with vascular cambium system, as the tissues were continuing to be developed.

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