• Journal of Chest Surgery
• /
• 제29권3호
• /
• pp.278-284
• /
• 1996

1989년 5월부터 1994년 5월까지 9명의 대혈관전위증 환자에 대해 동맥전환술을 시행하였다. 연령 분 포는 생후 3일에서 90일까지로 평균 30일 (21일)이 었고 환자는 전례 에서 술전 심초음파 검사로 진단되 었 다. 8례는 심실중격결손을 동반한 대혈관전위증이었으며 1례는 심실중격결손을 동반하지 않은 단순대 혈관잔위증 환아였다. 동반기형으로는 동맥관개존이 8례, 심방중격결손이 7El,대동맥축약이 1례였다. 관동백의 분지 형태는 Yacoub type A가 7례 (77 %), Yacoub type D의 형태가 2례 (23 %)였다. 폐동맥 재 건은 Lecompte 술식을 8례 에서 적용하였고 자가심낭편을 이용하였다. 사망율은 55 %였다. 수술후 1 ~2 일내 사망한 3례는 좌심실 기능부전과 발작성 폐동맥 고혈압이 원인이었고, 수술후 2~3주에 사망한 2례는 술후 감염에 의한 폐혈증이 주원인이었다. 평균 추적 기간은 17개월이 었고 추적관찰에는 심초음파 를 이용하였으며 임상적으로 의미 있는 대동맥 판 폐쇄부전이나 폐동맥 판 상부 협착은 발견되지 않았다. 수술에 따르는 여러 위험 요소들(저체중, 장시간의 체외순환, 체외 순환중 과도한 혈희석, 저체온, 술후 용적 부하, 과도한 \ulcorner\ulcorner\ulcorner사용) 중 술후 과도한 강심제를 사용했을 경우에서만 통계학적 유의성을 가지는 위험인자로 나타났다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제17권1호
• /
• pp.60-72
• /
• 1995

Temporomandibular joint ankylosis is the movemental obstacle of mandible which depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset, duration, anesthesia and treatment method, symptom, change of mouth opening, complication through medical record, X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis. The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul National University Hospital. 1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period of illness was 13.33 years. 2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation. 3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40.9% and the cases of using tracheostomy occupied 18.2%. 4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy (Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 36.6%. 5. In change of mouth opening reformed after surgery, Group III showed the best result of average 23.5mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation. Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining anatomaical & functional form, and then the development of various surgical methods will be requested.

• 디지털융복합연구
• /
• 제11권6호
• /
• pp.23-42
• /
• 2013

미의회는 증가하는 성범죄를 예방하고, 시민의 안전을 보호하기 위하여 성범죄자 등록 및 공개법을 통합 제정하였다. 즉, 2006년 미연방은 웨털링법(the Jacob Wetterling Act)과 메간법(Megan's Law)을 통합하여 AWA(the Adam Walsh Child Protection and Safety Act)를 제정하였다. AWA는 불일치하는 주법의 흠결을 제거하고, 성범죄자 등록 및 공개에 대한 국가적 기준을 제시하기 위한 목적을 갖고 있다. 그러나 AWA의 등록요건이 지나치게 포괄적이고, 처벌중심의 법이라는 비판을 받고 있다. 또한 AWA는 폭력범죄와 비폭력범죄를 구별하지 않고 등록을 요구하고 있으며, 심지어 청소년 성범죄자까지 등록대상으로 삼고 있다. 그런 이유로 납세자인 시민은 AWA의 이익향유자가 못 되고, 오히려 등록된 수많은 성범죄자들을 관리 감독하기 위해 필요한 재정적 부담을 짊어져야 할 처지에 놓여 있다. 따라서 재정적 부담을 줄이고, 시민과 성범죄자 모두에게 이익이 될 수 있도록 AWA는 흉악한 폭력범죄를 저지른 성범죄자로서 위험성이 있고, 재범의 가능성이 있는 범죄자만을 등록시키도록 해야 하며, 청소년 성범죄자들 특히, 비폭력적이며 재범의 가능성이 없는 청소년들은 적절한 치료를 우선적으로 받게 함으로써 재사회화될 수 있는 길을 열어주는 것이 바람직할 것이다.

• Journal of Chest Surgery
• /
• 제33권1호
• /
• pp.32-37
• /
• 2000

Background: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. Material and Method: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9$\pm$14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. Result: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. Conclusion: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.

• 한국병원경영학회지
• /
• 제13권4호
• /
• pp.27-45
• /
• 2008

This research focused on a total of 378 patients with external injuries under the age of 14 who visited the emergency center at a university hospital in Korea, during the months of January, April, August and November between January and December of 2007. In addition, the survey was conducted only on even number days and ranged across the whole year to reflect the impact of seasonal characteristics on the collected data. The research focused on determining the characteristics and inflicting cause of these patients with external injuries, analyzed the total time spent in the emergency room and obtained the following results. 1. When classifying the patients into different genders, the proportion of males (67.5%) was higher than that of females (32.5%). According to the different age groups, the highest ratio, at 61.1 %, was patients under the age of six. 2. Looking at the total number of minutes spent in the emergency room, the longest amount of time occurred during April with 162.7 minutes, followed by 121.9 minutes in January and 92.4 minutes in November. August had the shortest period of time spent in the emergency room, a significant statistical difference from the other periods of the year (p<0.001). 3. Regarding the amount of time required for each examination, patients required to provide a urine test spent an average of 204.7 minutes while those who did not spent 113.5 minutes on average. This is a 5% statistical difference among the two groups (p>0.05). 4. Looking at the five most commonly diagnosed problems in the emergency room, the total number of people with these top five commonly diagnosed illnesses comprised 55.6%, or 210 patients out of 378. 5. Utilizing the Decision Tree Model to estimate the total number of minutes required per visit, the first classifications were made using a chemical examination factor. People subject to chemical classification spent an average of 177.7 minutes, which was longer than the overall average of 115.2 minutes, and those exempt from chemical examination spent an average of 103.8 minutes, which was shorter than the average Conclusion; Effort to curtail the total time spent in emergency rooms is vital in guaranteeing efficient management of hospitals and providing medical services. The delay experienced by many comprehensive professional medical centers must be resolved through the establishment of effective delivery of medical services, increased supply of patient rooms and other policy oriented implementations. However, for now, this problem must be resolved by increasing the level of patient satisfaction and guaranteeing effective operation of patient rooms, which will significantly contribute to the general management and success of hospitals and institutions.

• 한국화재소방학회논문지
• /
• 제15권1호
• /
• pp.100-107
• /
• 2001

건물 내장재는 화재 발생 시 화염 확산 및 유독성 가스발생의 주원인으로 피난안전계획에 매우 중요하지만 다중이용업소의 인테리어 공사 시 화재성능에 대한 검증 없이 무분별하게 사용되고 있어 동일한 유형의 인명피해가 반복되고 있다. 따라서 본 연구에서는 국내 내장재 사용 실태조사를 통해 현행 관련규정상 문제점을 살펴보고, 이를 효과적으로 개선, 보완할 수 있는 방안을 제시하였다. 연구 결과, 구조체 밀착재를 제외한 내장재는 가칭 화재안전코드규정에서 사용규제하고, 소방·방화완비증명제도 시행 전 허가·신고된 다중이용업소는 건축법시행령에 소급하여 적용 할 수 있는 근거를 마련하며 지하 소규모 업소에 대한 소방방화시설 법제화, 내부 용도 변경 시 내장재사용 도면첨부 및 무단 변경 시 관련기관에 통보조치, 이동성가구에 대한 방염 처리 의무조항 신설, 화재확산 빛 연기 유독성을 기준으로 하는 재료등급 평가 및 시험방법의 개선이 필요한 것으로 사료된다.

• 산업경영시스템학회지
• /
• 제31권1호
• /
• pp.41-48
• /
• 2008

Enhanced machine reliability has dramatically reduced the rate and number of railway accidents but for further reduction human error should be considered together that accounts for about 20% of the accidents. Therefore, the objective of this study was to suggest a new taxonomy of performance shaping factors (PSFs) that could be utilized to identify the causes of a human error associated with railway accidents. Four categories of human factor, task factor, environment factor, and organization factor and 14 sub-categories of physical state, psychological state, knowledge/experience/ability, information/communication, regulation/procedure, specific character of task, infrastructure, device/MMI, working environment, external environment, education, direction/management, system/atmosphere, and welfare/opportunity along with 131 specific factors was suggested by carefully reviewing 8 representative published taxonomy of Casualty Analysis Methodology for Maritime Operations (CASMET), Cognitive Reliability and Error Analysis Method (CREAM), Human Factors Analysis and Classification System (HFACS), Integrated Safety Investigation Methodology (ISIM), Korea-Human Performance Enhancement System (K-HPES), Rail safety and Standards Board (RSSB), $TapRoot^{(R)}$, and Technique for Retrospective and Predictive Analysis of Cognitive Errors (TRACEr). Then these were applied to the case of the railway accident occurred between Komo and Kyungsan stations in 2003 for verification. Both cause decision chart and why-because tree were developed and modified to aid the analyst to find causal factors from the suggested taxonomy. The taxonomy was well suited so that eight causes were found to explain the driver's error in the accident. The taxonomy of PSFs suggested in this study could cover from latent factors to direct causes of human errors related with railway accidents with systematic categorization.

• 대한교통학회지
• /
• 제33권5호
• /
• pp.497-507
• /
• 2015

고속도로의 비반복 혼잡은 주로 돌발상황에 의해 발생된다. 돌발상황의 주요 원인은 교통사고로 알려져 있다. 따라서 교통사고 시 사고처리시간을 정확하게 예측하는 것은 돌발상황 관리에서 매우 중요하다. 본 연구에서는 전국고속도로의 2008-2014년 총 7년치(60,473건)의 사고 자료를 이용하였다. 사고처리시간 예측모형은 과거의 교통사고 이력자료를 바탕으로 비모수모형인 KNN (K-Nearest Neighbor) 알고리즘을 활용하였다. 사고자료 현황 분석결과 사고등급별로 사고처리시간에 미치는 영향이 매우 큰 것으로 분석되었다. 따라서 사고처리시간은 사고등급별로 분류하여 모형을 구축하였다. 그리고 현재 발생한 사고의 교통상황과 도로 기하구조를 반영하기 위하여 교통량, 차로수, 시간대를 구분하여 데이터를 추출하였다. 추출된 데이터 중 현재 교통사고와 유사한 사고를 검색하기 위하여 사고처리시간에 영향을 미치는 요인들을 분석하였다. 마지막으로, 상태간 거리 산정을 위해서 세부항목별 가중치를 산정하였다. 가중치산정은 정규분포 표준화방법을 적용하였고, 이를 통해 사고처리시간을 예측하였다. 본 연구에서 개발된 모형의 예측결과는 기존의 연구들의 결과에 비해 낮은 예측오차(MAPE)를 보여 모형의 우수성을 입증할 수 있다고 판단된다. 본 연구를 통해 고속도로의 돌발상황 발생 시 효율적인 고속도로의 운영관리에 기여할 수 있고, 기존의 모형들이 갖고 있던 한계를 개선 및 보완할 수 있을 것으로 판단된다.

• 대한원격탐사학회:학술대회논문집
• /
• 대한원격탐사학회 2008년도 International Symposium on Remote Sensing
• /
• pp.348-357
• /
• 2008

The classification of the effect of ionospheric disturbances on the radio occultation signal amplitude has been introduced based on an analysis of more than 2000 seances of radio occultation measurements per formed with the help of the CHAMP German satellite. The dependence of the histograms of variations in the radio occultation signal amplitude on the IMF variation index has been revealed. It has been indicated that it is possible to introduce the radio occultation index characterizing the relation between ionospheric disturbances and solar activity. An amplitude radio occultation (RO) method is proposed to study connection between the ionospheric and solar activity on a global scale. Sporadic amplitude scintillation observed in RO experiments contain important information concerning the seasonal, geographical, and temporal distributions of the ionospheric disturbances and depend on solar activity. The probability of strong RO amplitude variations (RO $S_4$ index greater than 0.2) in the CHAMP RO signals diminishes sharply with the weakening of solar activity from 2001 to 2008. The general number of RO events with strong amplitude variations can be used as an indicator of the ionospheric activity. We found that during 2001-2008 the daily globally averaged RO $S_{4a}$ index depends essentially on solar activity. The maximum occurred in January 2002, minimum has been observed in summer 2008. Different temporal behavoir of $S_{4a}$ index has been detected for polar (with latitude greater than $60^{\circ}$) and low latitude (moderate and equatorial) regions. For polar regions $S_{4a}$ index is slowly decreasing with solar activity. In the low latitude areas $S_{4a}$ index is sharply oscillating, depending on the solar ultraviolet emission variations. The different geographical behavoir of $S_{4a}$ index indicates different origin of ionospheric plasma disturbances in polar and low latitude areas. Origin of the plasma disturbances in the polar areas may be connected with influence of solar wind, the ultraviolet emission of the Sun may be the main cause of the ionospheric irregularities in the low latitude zone. Therefore, the $S_{4a}$ index of RO signal is important radio physical indicator of solar activity.

• 대한한방종양학회지
• /
• 제9권1호
• /
• pp.75-87
• /
• 2003

Recently, the occurrence and death rates of cancer have increased rapidly. Metastasis and recurrence is the most important factor of death from cancer. So inhibition of recurrence and metastasis can increase the cure rate of cancer disease. At the basic chinese traditional medicine(TCM), there are a lot of theory related to neoplasm treatment. The metastasis and recurrence of neoplasm was the basis of yudu(餘毒) on remained neoplasm cell and stagnation of blood, thermotoxo, phlegm, asthenia of healthy enerngy and stagnation of vital energy. The principles therapy of neoplasm on metastasis and recurrence was based on knowledge of the method of support the healthy energy and strengthen the body resistance, promote blood circulation to remove blood stasis, clear away heat and toxic materials, dissipate phlegm and disperse the accumulation of evils. But the major clinical features of neoplasm was to be considered in developing a treatment plan include (1) distinguish between clinical and pathologic staging - acute and chronic, (2) classification of pathologic pattern, and (3) distingction of body situation : for examples asthenia - sthenia etc. It was most important to distinguish between supporting the healthy and eliminating the evil factors and to treat differently at the root and the branch cause of a neoplasm. This paper's results indicate that identification and effective use of THM can inhibite netastasis and recurrence and then it will help increasing survival rate. Also as BioTechnology(BT) has developed rapidly nowadays, as genes related to cancer have revealed. So it will give rise to the development of searching the mechanism of herb medicines which have inhibition effects of metastasis and recurrence.