• Title/Summary/Keyword: 환자의 접근

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미국 유기양돈의 생산과 유통 -현황과 농가의 결정에 영향을 미치는 요인들-

  • 크리스보에센
    • Proceedings of the Korean Society of Organic Agriculture Conference
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    • 2001.10a
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    • pp.207-218
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    • 2001
  • 미국의 콘벨트와 같이 곡물을 집약적으로 재배하는 지역에서 관행생산으로부터 유기적 생산으로 전환할 때 문제가 되는 것은 어떻게 하면 작물윤작을 더 많은 이익이 나올 수 있도록 선택하고 관리하는가 하는 점이다. 곡물생산을 중단하고 사료와 녹비작물을 재배하는데 드는 기회비용은 상당하다. 많은 유기농업 연구자, 학자들은 가축사육을 농장에 도입하여 다양화와 노동력 활용도를 높일 필요가 있음을 강조하고 있다. 가축 역시 곡물생산량이 줄어드는 것을 보완해줄 정도로 곡물 및 사료작물의 가치를 늘려 추며, 곡물생산에 쓰여진 양분을 퇴비를 통해 재활용할 수 있게 해 준다. 곡물 집약재배 지역에서 유기농가는 양돈이 경종체계에 자연스럽게 들어맞는 것으로 생각해 볼 필요가 있다. 돼지는 곡물과 사료작물 모두에 가치를 증대시켜 줄 수 있는 아주 효율적이고 적용이 쉬운 가축이다. 그다지 많지는 않지만 유기적, 지속가능한 양돈 생산에 관해서는 문헌이 좀 있다. 그러나 유기농가로 하여금 유기양돈 생산을 하도록, 그리고 유통의 방법을 어떻게 할 것인가 결정을 내리는데 도움을 줄 수 있는 그런 비교적 구체적인 정보는 그리 많지 않다. 이 글의 주요 초점은 미국 중부지방에서의 유기축산 생산(주로 돼지)에 관한 배경과, 시장의 추세, 인구적 특성, 미국의 기준들에 비추어 생산과 유통에 관한 결정 및 고려사항들에 대한 개관을 제시해 보는 일이다. 농장 수준에서 의사결정은 토지, 노동, 금융과 사회적 자본과 같은 자원을 각종 기회와 더불어 고려하여 이루어져야 한다. 이러한 결정은 모두 농장 차원을 넘어 각종 기준과 시장에서의 세력들의 맥락을 보고 이루어져야 한다. 각 개인의 수준에서는 농업인 역시 유기 흑은 환경친화적 농업에 관한 확신, 바꾸어 보겠다는 결심, 생활양식과 가족에 대한 영향, 그리고 농업인과 가족 경영에 대한 계획의 지평이라고 하는 범위 내에서의 유기적 방식으로의 전환에 관하여 결정을 내려야 한다.aotic motion)의 해석도 가능하다. 이 글에서는 비선형 진동해석을 위한 정규모드 동역학에 대한 연구동향 및 기본 이론을 살펴 보았고, 그 적용 예를 통하여 실험결과와 비교 고찰 함으로써 정규모드 동역학의 적용성을 서술하여 보았다. 선형이론으로 이해하기 어려운 현상들에 대하여는 비선형의 관점에서 새롭게 접근하 려는 노력이 필요하며 비선형 이론에 대한 연구가 지속적으로 진행되어야 한다. 진행되어야 한다.VA코드를 사용하여 흡기포트와 연소실 그리고 밸브의 움직임을 동시에 고려한 수치해석을 도입하였다. 하지만 이들이 밸브의 운동을 고려하기 위해 사용한 이동격자는 격자점은 시간에 따라 변화하지만 그 격자의 수가 일정하게 유지되어 있어서 밸브의 완전개폐를 해석할 수가 없다. 강희정[6]은 단일 실린더와 단일 배기밸브를 갖는 문제로 단순화하여 피스톤과 밸브의 움직임을 고려하므로써 배기행정 후 소음이 어떻게 전파해 나가는가를 연구하였다. 본 연구에서도 최소밸브간격과 최대밸브간격 사이에서만 계산이 가능하나 흡기의 경우는 밸브가 닫힐 때 생기는 압력파가 중요하므로 실린더와 밸브사이에 벽면조건을 주어 밸브의 개폐를 모사하였다.술을 보유하고자 한다. 이용한 해마의 부피측정은 해마경화증 환자의 진단에 있어 육안적인 MR 진단이 어려운 제한된 경우에만 실제적 도움을 줄 수 있는 보조적인 방법으로 생각된다.ofile whereas relaxivity at high field is not affected by τS. On the other hand, the change in τV does not affect low field profile but strongly in fluences on both inflection fie이 and the maximum relaxivity value. The results shows a fluences on both inflection field and the maximu

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Thoracic Surgeon's Role in Differential Diagnosis of the Interstitial Lung Disease (간질성 폐질환의 확진을 위한 흉부외과의 역할)

  • Kim Sung-Whan;Yahang Jun-Ho;Kim Jong-Woo;Choi Jun-Young;Rhie Sang-Ho;Jang In-Seok
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.382-386
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    • 2006
  • Background: Pathologic confirmation is needed to diagnose various forms of interstitial lung diseases. We wanted to find out how much the thoracic surgical lung biopsies will be needed for definite diagnosis of interstitial lung diseases. Material and Method: 17 patients underwent surgical lung biopsy in the department of thoracic and cardiovascular surgery, Gyeongsang National University Hospital from June 1995 to November 2002. Chart review and telephone questionnaire were done for retrospective study. Result: Mean age was $49{\pm}22$ years. Age ranged from 1 to 70 years. Dyspnea was the most common complaint. They were referred for definite differential diagnosis from pediatrics and internal medicine. Biopsy methods were thoracotomy in 11 cases, and thoracoscopy in 6 cases. Pathologic confirmation was possible in 11 cases (65%). According to the pathologic reports, treatment plans were changed in 13 cases (76%). Conclusion: Surgical lung biopsy was effective method in differentiating diagnosis of the interstitial lung disease, There was no mortality during operation. It is important that undiagnosed fibrous lung disease should be recommanded the lung biopsy for planning patient's treatment.

Videothoracoscopic Sympathectomy in Hyperhidrosis (다한증의 흉강경을 이용한 교감신경절 절제술)

  • 이재영;김명천;조규석
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.279-285
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    • 1998
  • Exessive sweating of the palms and soles, is a psychologically and occupationally distressing and sometimes disabling condition. Hyperhidrosis is one of the common abnormalities in autonomic nervous system. There were no specific treatment on hyperhidrosis, so invasive thoracic sympathectomy via axillary thoracotomy or cervical approach had been used. Video-assisted thoracic surgery(VATS) is now mostly performed for treating of the palmar and axillary hyperhidrosis. From March 1996 to March 1997, 15 patients with bilateral palmar hyperhidrosis had been treated by the bilateral thoracic sympathectomy(T2, T3, T4) with thoracoscopic resection. The patient were evaluated preoperative and postoperative Digital Infrared Thermographic Imaging (DITI) at Kyung-Hee University Hospital. There were no case of the thoracotomy conversion. There were 3 complications ; pulmonary edema in 1 case, Horner's syndrome in 1 case, and gustatory hyperhidrosis in 1 case. More than half of the patients also had compensatory sweating in the lower abdomen, the buttocks, the back and the thighs. In conclusion, most of the patients were satisfied with the postoperative results of the thoracoscopic sympathectomy, including no more palmar and axillary sweating, less pain, better cosmetic appearances, decreased sweating of the face and soles. In addition, intraoperative temperature monitoring of the hands could estimate the successful thoracoscopic sympathectomy and the preoperative and postoperative Digital infrared thermographic imaging(DITI) could especially be the technique for the objective manifestation of the successful results of the thoracoscopic sympathectomy.

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The Relationship between HbA1c Control and Diabetes Self-care Knowledge, Competence, Behavior and Quality of Life on Diabetes elderly (노인 당뇨환자에서 당뇨 자가관리 지식, 자신감, 행위 및 삶의 질과 당화혈색소 조절의 관련성)

  • Lee, Song-heun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.357-366
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    • 2017
  • This study was conducted to identify the diabetes self-care (DSM) knowledge, DSM competence, DSM behavior, and quality of life according to HbA1c control in diabetic elderly. The participants were 205 diabetes elderly who visited the citizen health promotion center located in D city, Korea. Data were collected from April, 4 to August 31 2015, and were analyzed by the t-test and chi-squared test using IBM SPSS 23.0. The mean scores of DSM knowledge, DSM competence, DSM behavior and quality of life were $50.61{\pm}16.39$, $71.27{\pm}10.21$, $62.78{\pm}1.29$ and $0.86{\pm}0.11$, respectively. Additionally, DSM behavior (t=2.17, p=0.031), education level (t=11.80, p=0.0019) l, BMI (t=0.001, p=0.012), and number of visits to citizen health center (t=16.497, p=0.001) differed significantly between the controlled HbA1c group and uncontrolled HbA1C group. However, ANCOVA revealed that the level of HbA1c did not affect the DSM behaviors. Therefore, it is necessary to develop and apply a DSM education program that reflects the characteristics knowledge level of the elderly. In addition, healthcare institutions with high accessibility in terms of distance and cost to guide and manage desirable diabetic self-care behaviors should be provided everywhere.

Study on the Development and Application of Image Viewer System (Image Viewer System의 개발 및 적용에 관한 고찰)

  • Yang, Oh-Nam;Seo, In-Ki;Hong, Dong-Ki;Kwon, Kyeong-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.2
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    • pp.67-73
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    • 2006
  • Purpose: The number of patients receiving radiotherapy has increased every year and will keep increasing in the future. Therefore, the technique of radiotherapy is developing from day to day, as a result of it, the quantities of image and data used for radiotherapy are also considerably increasing. Therefore, there have been many difficulties in storing, keeping and managing them. Then, we developed and applied this system for improving complicated work process as well as solving these problems with the collaboration Medical Information Team. Materials and Methods: We exported its image at R & V (Record and Verify: Varis vision, Varian, USA) system and planning system after giving some code to be able to access from management system(RO) for department of radiation oncology to PACS. And, we programmed their information by using necessary information among many information included in DICOM head. Results: All images and data generated by our working environment (Simulation CT, L-gram image and internal body structure, DRR, does distribution )were realized at PACS and it became to be possible for clear image to be printed from any computer in department of radiation oncology. Conclusion: It was inevitable to use film during radiotherapy for patients in the past, however, due to the development of this system, film-less system became to be possible. Therefore, the darkroom space and its management cost in relation to the development process disappeared and it became to be unnecessary for spending tangible and intangible financial expense including human resources, time needed for finding film storing space and film and purchasing separate storing equipment for storing images. Finally, we think this system would be very helpful to handle ail complicated processes for radiotherapy and increasing efficiency of overall working conditions.

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Self-inflicted Tongue Ulceration in a Patient with Tourette Syndrome: A Case Report (뚜렛 증후군 환자에서 자해로 인한 혀 손상 : 증례 보고)

  • Lee, Kkotnim;Kim, Miae;Hwang, Inkyung;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.327-333
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    • 2016
  • Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

The esthetic prosthodontic treatments in maxillary anterior area, considering the gingival margin (치은 변연을 고려한 상악 전치부의 심미 수복 증례)

  • Son, Daheen;Paek, Janghyun;Woo, Yi-Hyung;Kim, Hyeong-Seob
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.438-444
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    • 2016
  • To enhance the esthetic appearance, the maxillary anterior area is important. It is possible to improve the esthetic appearance through the treatment of maxillary anterior area, which includes altering the color, form, and arrangement of teeth. When planning these treatments, clinicians should individualize personal demands, by using the information obtained from facial, dento-labial, dental, and gingival analysis. It is essential to properly prepare the gingival structure, which includes the height of gingival margin, the location of zenith, reconstruction of the interdental papillae, emergence profile, and symmetry. Clinicians often face unfavorable condition of the gingiva and the edentulous ridge, and appropriate management of the gingival structure is needed. In this case report, the patients were treated to improve the gingival conditions surrounding maxillary anterior teeth. By using conservative treatment without surgical intervention, such as application of pink porcelain, subgingival contour modelling and modification of pontic base, satisfactory esthetic results were gained.

An Inquiry to the Causal Perceptions & Emotions of Rheumatoid Arthritis Patients (류마티스 관절염 환자의 원인지각에 대한 연구 - Q방법론적 접근 -)

  • Kim, Boon-Han;Jung, Yun
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.226-241
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    • 1999
  • This study was undertaken to find out the causal perception of rheumatoid arthritis patients, and to understand the typology. The Q-population consisted of 236 statements of causal perception were collected. Thirty eight Q-samples of causal perception were selected. The P-sample for this study were made up of 28 first visiting female rheumatoid arthritis patients from a rheumatoid arthritis specialty hospital. Each respondent responded Q-set of causal perception according to 9-point scale. The result of Q-sorting were coded and analyzed using QUANL PC program. 1) Typological Observation on Causal Perception (1) Physical Fatigue Type : Type 1 perceived that the illness occurred due to excessive work requiring physical labor or strain that had occurred from not resting after excessive physical labor, therefore, thinking the origin of the illness was from physical strain. (2) Physical origin Type : Type 2 perceived that the major cause for the illness is not only excessive physical labour but also fecundity and old age. (3) Causality to Environment Type : Type 3 perceived that rheumatoid arthritis occurred from injury to the joints or bad and humid weather. (4) Conscience of Guilty Type : Type 4 consisted of people with guilty conscience for lack of religious commitment. They perceived that the illness was a punishment from God for not praying or because of bad luck. (5) Rationally Perceiving Type : People who belong in type 5 perceived the cause of illness in light of scientific facts such as genetics, unbalanced diet or lack of exercise. (6) Psychological Stress Type : People who belong in type 6 believed that excessive stress was the cause of the illness. 2) Emotions of Rheumatoid arthritis patients Rheumatoid arthritis patients' positive emotions included determination, courage, coping, acceptance, hope, and adoption ; and their negative emotions were prostration, worry, stupor, conflicts, grievance, giving-up, resignation, depression, loss, solitariness, fear, anxiety, avoidance, anger and loneliness. Rheumatoid arthritis patients experience different level of emotions from their suffering experience from the severe pains. Rheumatoid arthritis patients also experience negative emotions when they could not perform self-care and lose their self-esteem from painful suffering ; however, they regain positive emotions when they recover from pain with the use of drugs, physical therapy or exercise. Their emotional states are closely connected to level of and presence of pain.

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Effects of Proprioceptive Neuromuscular Facilitation Program Combined with Dynamic Neuromuscular Stabilization Approach on Balance in Patient with Cerebellum Atrophy -Case Report- (동적 신경근 안정화 접근법과 결합한 PNF 중재 프로그램이 소뇌 위축 환자의 균형에 미치는 영향 -사례보고-)

  • Na, Eun-Jin;Moon, Sang-Hyun;Kim, Eun-Kyung;Park, Du-Jin
    • PNF and Movement
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    • v.14 no.3
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    • pp.237-244
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    • 2016
  • Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.

Vibration Test for PCB/Connector Assembly (인쇄회로기판 진동이 커넥터에 미치는 영향)

  • 허남일;김성철;송규섭
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 1995.10a
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    • pp.160-164
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    • 1995
  • 정보통신 시스템의 고속/고밀도화 요구에 따라 개발되고 있는 ATM(Asynchronous Transfer Mode) 교환기 시스템은 팬을 이용한 강제대류냉각 방식의 채택과 시스템이 설치되는 장소에 따른 여러 환경조건에 의한 진동 문제가 발생될 수 있다. 시스템의 진동으로 인한 피해중 커넥터 접촉부에서 전기적 특성의 변화는 고속으로 전송되는 신호의 왜곡을 유발시킬 수 있어 시스템 개발시 이에 대한 충분한 연구 및 시험이 요구되고 있다. 진동환경에서 커넥터 접촉부는 접촉면의 상대운동으로 인한 접촉저항의 증가와 순간적인 신호전달 중단을 가져오게 되며, 특히 PCB/Connector Assembly에서 커넥터 접촉부는 PCB(Printed Circuit Board)의 장착 조건 및 동적 거동에 따라 전기적 특성이 변할 수 있다. 시스템에서 커넥터의 동적 거동을 이해하기 위해서는 PCB를 포함하는 시스템내 여러 요소의 동적 특성 이해와 복잡한 해석과정이 요구되며, 시스템 개발자는 진동 환경에서 이것의 시험 결과에 따라 커넥터의 사용을 결정해야 할 것이다. 커넥터의 전기적 특성 시험법은 IEC, EIA드 여러 국제 규격에 제시되어 있으며, 본 연구의 대상이 된 ATM교환기 시스템에서 PCB/Connector Assembly의 진동환경에서 접촉저항 측정과 관련된 접촉저항 임계치 및 측정법은 IEEE 규격 및 Bellcore 규격에 규정되어 있다. Bellcore에는 주어진 진동시험주기 전후에 IEC 규격의 LLCR(Low Level Contact Resistance) 측정회로를 이용한 측정법이 규정되어 있고, 냉각팬 및 주위 환경진동이 가해지는 동안의 영향에 대한 시험법은 규정되어 있지 않다. 본 연구에서는 한국통신의 전자장비 운용환경시험 조건의 진동에서 ATM 교환기 시스템에 사용되는 PCB/Connector Assembly 커넥터 접촉부의 접촉저항 변화와 PCB 진동에 의한 영향을 시험하였다.proach)등이 제시되었고 평면파 영역에 한하여 해서되어져 왔다. 본 논문에서는 분할 접근 방법(Segmentation Approach)을 이용하여 다공 요소로 이루어진 소음기를 해석하는데 적용하였다.로 성능 및 안정도에 영향을 미치므로 주의 깊게 선정해야 한다. 방법의 실질적인 적용에는 어려움이 있다. 본 연구에서는 기존의 방법들의 단점을 극복할 수 있는 새로운 회귀적 모우드 변수 규명 방법을 개발하였다. 이는 Fassois와 Lee가 ARMAX모델의 계수를 효율적으로 추정하기 위하여 개발한 뱉치방법인 Suboptimum Maximum Likelihood 방법[5]를 기초로 하여 개발하였다. 개발된 방법의 장점은 응답 신호에 유색잡음이 존재하여도 모우드 변수들을 항상 정확하게 구할 수 있으며, 또한 알고리즘의 안정성이 보장된 것이다.. 여기서는 실험실 수준의 평 판모델을 제작하고 실제 현장에서 이루어질 수 있는 진동제어 구조물에 대 한 동적실험 및 FRS를 수행하는 과정과 동일하게 따름으로써 실제 발생할 수 있는 오차나 error를 실험실내의 차원에서 파악하여 진동원을 있는 구조 물에 대한 진동제어기술을 보유하고자 한다. 이용한 해마의 부피측정은 해마경화증 환자의 진단에 있어 육안적인 MR 진단이 어려운 제한된 경우에만 실제적 도움을 줄 수 있는 보조적인 방법으로 생각된다.ofile whereas relaxivity at high field is not affected by τS. On the other hand, the change in τV does not affect low field profile but strongly in fluences on both inflection fie이 and the maximum relaxivity value. The results shows a fluences on both inflection field and the maximum relaxivity v

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