• 제목/요약/키워드: Operation factors

검색결과 3,658건 처리시간 0.031초

좌내흉동맥-요골동맥 복합이식편을 이용한 다중혈관 관상동맥우회술 (Multivessel Coronary Revascularization with Composite LITA-RA Y Graft)

  • 이섭;고무성;박기성;류재근;장재석;권오춘
    • Journal of Chest Surgery
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    • 제39권5호
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    • pp.359-365
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    • 2006
  • 배경: 동맥도관은 관상동맥우회술의 장기성적을 향상시키기 위해 사용되어 왔다. 양측 내유동맥 이식편은 좋은 결과를 보이나, 당뇨병과 만성폐쇄성폐질환 등에서는 그 사용이 제한적이다. 저자들은 다중혈관 관상동맥우회술에서 복합 좌내흉동맥-요골동맥 Y 이식편의 외과적 결과를 평가하였다. 대상 및 방법: 2002년4월부터 2004년 9월까지 복합 Y 이식을 시행한 119명의 환자를 대상으로 하였다. 평균 연령은 $62.6{\pm}8.8$세였으며, 여자는 34.5%였다. 수술 전 위험요소는 다음과 같다. 고혈압 43.7%, 당뇨병 33.6%, 흡연 41.2%, 고지질혈증 22.7%였다. 응급수술 14예, 심인성 쇼크 6예, 40% 이하의 좌심실 박출계수 17예, 좌주간 관동맥질환 17예였다. 퇴원 전 35예에서 관상동맥 조영술을 시행하였다. 결과: 평균 원위 문합수는 $3.1{\pm}0.91$개, 병원 사망률은 3예(2.52%)였다. 79예(66.4%)에서 인공심폐기를 사용하지 않은 관상동맥 우회술(off-pump coronary bypass grafting, OPCAB)을 시행하였다. 좌측 내흉동맥은 좌전하행지(l16개)와 대각지(9개)에 문합하였다. 요골동맥은 둔각변연지(109개), 중외관지(21개), 후하행지(45개), 후측방지(5개) 등에 문합하였고, 대복제 정맥은 후하행지(45개), 후측방지(12개), 대각지(17개), 둔각변연지(3개) 등에 문합하였다. 수술 후 시행한 관상동맥 조영에서 좌측 내흉동맥 100%, 요골동맥에서는 88.5%의 우수한 개통률을 보였다. 전례에서 내흉동맥-요골동맥 문합부위의 폐쇄나 협착은 없었으나 70% 미만의 협착을 보인 관상동맥에 문합한 3예의 요골동맥편에서 string sign이 나타났다. 결론: 좌내흉동맥-요골동맥 Y 복합이식은 다중혈관 관상동맥우회술에서 우수한 조기 임상 및 혈관조영 결과를 확인할 수 있었으며 선택적으로 시행할 수 있다.후 유리혈장색소는 $T-PLS^{TM}$군에서 유의하게 낮게 측정되었다$(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;vs\;46.8{\pm}23.0\;in\;Bio-pump^{TM},\;p<0.05)$. 수술 후 심근경색, 부정맥, 신부전, 뇌혈관질환 이환율은 두 군에서 차이가 없었다. 수술 후 사망은 $T-PLS^{TM}$군에서 1예(5%) 발생하였으나 통계적 유의성은 없었다. 결론: 박동성 혈류펌프인 $T-PLS^{TM}$를 이용하여 심폐기하 관상동맥 우회술을 시행하였다. 수술 중 기계오류에 의한 사고는 없었고 수술 후 임상경과가 $Bio-pump^{TM}$를 이용하여 수술한 경우와 차이가 없었다. 또한 박동성 혈류의 문제점이었던 혈구손상은 감소하였다. 저자들은 본 연구를 통해 $T-PLS^{TM}$의 안정성을 확인하였다.. 경우에는 8-aza-bicyclo[3,2,1]octan-3-one ring들의 steric hindrance의 영향에 의해 1,3-di-8-aza-bicyclo[3,2,1]octan-3-onyl)benzene은 합성되지 않았다.료된다. 또한 본 연구를 통해 도출된 선택속성 차원 중 많은 경우에 있어 고객이 인지하고 있는 중요도에 비해 수행도가 낮은 것으로 나타나 해당 차원의 개선을 위한 경영자들의 노력이 요구되어 진다. 체중군(0.82)에 비해 영양 질적 지수(INQ)가 높았으며(p<0.0335), 비타민 $B_1$은 정상 체중군이 유의적으로 가장 높은 영양 질적 지수를 보여주었다(p<0.0452). 이상의 결과로 볼 때 대학생들은 과체중보다는 저체중의 비율이 높았으므로 적정 체중 유지와 더불어 잘못된 식습관과 식이 섭취를 하고 있었다. 이에 대한 인식과 이를 교정할 수 있는 영양 교육이나 이를 토대로 한 세대를 짊어질 대학생들의 영양

전자빔 공정에서 실험계획법을 이용한 살균제 Benomyl의 제거특성 및 독성평가 (Decomposition Characteristics of Fungicides(Benomyl) using a Design of Experiment(DOE) in an E-beam Process and Acute Toxicity Assessment)

  • 유승호;조일형;장순웅;이시진;천석영;김한래
    • 대한환경공학회지
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    • 제30권9호
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    • pp.955-960
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    • 2008
  • 본 연구는 전자빔 공정에서 실험계획법(design of experiment: DOE) 중 일반요인배치법(general factorial design)을 이용하여 2개 인자(X$_1$: benomyl concentration(mg/L), X$_2$: E-beam irradiation(Gy))를 토대로 요인(X$_1$: benomyl concentration) 1에서 3개 수준(3 level: 0.5, 1 및 1.5 mg/L)와 요인(X$_2$: E-beam irradiation) 2에서 6개 수준(6 level: 100, 800, 600, 400, 200 및 100 Gy)으로 구성된 3블록(block) 실험조합에 따라 Benomyl의 분해(Y$_1$: the % of decomposition), 무기화(Y$_2$: the % of materialization) 및 독성평가(acute toxicity assessment)를 수행하였다. 우선 HPCL 분석에 의한 Benomyl에 분해특성은 처리조합(treatment combination) 3 블록(block)의 17 및 18번을 제외한 모든 실험조건에서 100% 분해되었고 등분산(equal variance) 조건에서 일원분산분석(one-way ANOVA)결과 수준 간 유의한 차이가 없었다(p > 0.05). 전자빔 조사에 의한 Benomyl에 무기화(materialization) 특성은 각 3개의 처리조합에서 평균 46%, 36.7% 및 22%의 제거효율을 나타났고 각 조합에서 처리수준 간 예측식은 block 1(Y$_1$ = 0.024X$_1$ + 34.1(R$^2$ = 0.929)), block 2(Y$_2$ = 0.026X$_2$ + 23.1(R$^2$ = 0.976)) 및 block 3(Y$_3$ = 0.034X$_3$ + 6.2(R$^2$ = 0.98)) 등의 1차 선형 회귀식을 만족하였다. 또한 Benomyl에 무기화(materialization)에 대한 Anderson-Darling 검정을 이용한 정규성(normality)을 만족하였다(p > 0.05). 또한 무기화에 대한 반응에 대한 선형 및 비선형을 포함한 다중회귀분석(multi regression analysis)을 도출한 결과 다음과 같은 예측식 Y = 39.96 - 9.36X$_1$ + 0.03X$_2$ - 10.67X$_1{^2}$ - 0.001X$_2{^2}$ + 0.011X$_1$X$_2$(R$^2$ = 96.3%, Adjusted R$^2$ = 94.8%)을 도출하였다. 2가지 반응변수(X$_1$: benomyl concentration(mg/L), X$_2$: E-beam irradiation(Gy))에 의한 2차 반응표면 모형식 추정으로부터 정준분석을 통해 최적조건을 도출한 결과 Benomyl 초기농도(X$_1$) 0.55 mg/L, 전자빔 조사량 950 Gy에서 TOC 제거율 57.3%으로 나타났다. 마지막으로 V. fischeri를 이용한 MicrotoxTM modified 81.9% test을 이용하여 전자빔에 의한 Benomyl에 대한 급성 독성을 평가한 결과 전자빔 조사전 block 1의 0.5 mg/L에서 10.25%, block 2의 1 mg/L에서 20.14% 및 block 3의 1.5 mg/L에서 26.2%의 생물학적 방해(inhibition)작용이 발생하였으나 전자빔 조사 후 모든 조건에서 생물학적 방해영향을 나타나지 않았다.

UV 공정을 이용한 N-Nitrosodimethylamine (NDMA) 광분해 및 부산물 생성에 관한 연구: 박스-벤켄법 실험계획법을 이용한 통계학적 분해특성평가 및 반응모델 수립 (A study on the Degradation and By-products Formation of NDMA by the Photolysis with UV: Setup of Reaction Models and Assessment of Decomposition Characteristics by the Statistical Design of Experiment (DOE) based on the Box-Behnken Technique)

  • 장순웅;이시진;조일형
    • 대한환경공학회지
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    • 제32권1호
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    • pp.33-46
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    • 2010
  • 본 연구는 광분해 산화공정으로 난분해성 물질인 N-Nitrosodimethylamine (NDMA)인 제거 및 부산물 생성 특성을 파악하기 위한 3개의 독립변수 (자외선 강도($X_1:\;1.5{\sim}4.5\;mW/cm^2$, 초기 NDMA 농도($X_2:\;100{\sim}300\;uM$), pH(X3:3~9))와 4개의 종속변수(NDMA 제거율($Y_1$), dimethylamine (DMA) 생성농도($Y_2$), dimethylformamide (DMF) 생성농도($Y_3$) 및 $NO_2$-N 생성농도($Y_4$))로 구성된 박스-벤켄 설계를 이용한 실험계획을 적용시켜 예측 모델과 광분해 산화 최적조건을 수립하였다. 실험결과 2시간 광분해 후 NDMA는 거의 완전히 제거되었으며 DMA, DMF와 $NO_2$-N은 NDMA 광분해와 동시에 부산물로 생성되었다. 광분해 최적의 조건을 얻기 위해 정준분석을 수행하여 최적 점 (반응값, 독립변수 조건)과 예측반응모델을 수립한 결과, 다음과 같은 결과를 얻었다 ($Y_1=117+21X_1-0.3X_2-17.2X_3+{2.43X_1}^2+{0.001X_2}^2+{3.2X_3}^2-0.08X_1X_2-1.6X_1X_3-0.05X_2X_3$ ($R^2$ = 96%, Adjusted $R^2$ = 88%)와 99.3% ($X_1:\;4.5\;mW/cm^2$, $X_2:\;190\;uM$, $X_3:\;3.2$), $Y_2=-101+18.5X_1+0.4X_2+21X_3-{3.3X_1}^2-{0.01X_2}^2-{1.5X_3}^2-0.01X_1X_2-0.07X_1X_3-0.01X_2X_3$ ($R^2$= 99.4%, 수정 $R^2$ = 95.7%)와 35.2 uM ($X_1:\;3\;mW/cm^2$, $X_2:\;220\;uM$, $X_3:\;6.3$), $Y_3=-6.2+0.2X_1+0.02X_2+2X_3-{0.26X_1}^2-{0.01X_2}^2-{0.2X_3}^2-0.004X_1X_2+0.1X_1X_3-0.02X_2X_3$ ($R^2$= 98%, 수정 $R^2$ = 94.4%)와 3.7 uM ($X_1:\;4.5\;mW/cm^2$, $X_2:\;290\;uM$, $X_3:\;6.2$), $Y_4=-25+12.2X_1+0.15X_2+7.8X_3+{1.1X_1}^2+{0.001X_2}^2-{0.34X_3}^2+0.01X_1X_2+0.08X_1X_3-3.4X_2X_3$ ($R^2$= 98.5%, 수정 $R^2$ = 95.7%)와 74.5 uM ($X_1:\;4.5\;mW/cm^2$, $X_2:\;220\;uM$, $X_3:\;3.1$). 반응표면분석법 중 하나인 박스-벤켄법은 UV 광분해에 의한 NDMA 분해 및 부산물 생성에 대한 통계학적 및 수학적인 결과 및 최적의 운전조건을 제시하였다. 예측모델의 검정을 통하여 박스-벤켄법은 매우 높은 신뢰성을 보였다.

계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로- (The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery)

  • 이소우
    • 대한간호학회지
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    • 제12권2호
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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방화범죄의 실태와 그 대책 - 관심도와 동기의 다양화에 대한 대응 - (The Reserch on Actual Condition of Crime of Arson Which Occurs in Korea and Its Countermeasures)

  • 최종태
    • 시큐리티연구
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    • 제1호
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    • pp.371-408
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    • 1997
  • This article is the reserch on actual condition of crime of arson which occurs in Korea and its countermeasures. The the presented problem in this article are that (1) we have generally very low rate concern about the crime of arson contrary to realistic problems of rapid increase of crime of arson (2) as such criminal motives became so diverse as to the economic or criminal purpose unlike characteristic and mental deficiency of old days, and to countermeasure these problems effectively it presentation the necessity of systemantic research. Based on analysis of reality of arson, the tendency of this arson in Korea in the ratio of increase is said to be higher than those in violence crime or general fire rate. and further its rate is far more greater than those of the U.S.A. and Japan. Arson is considered to be a method of using fire as crime and in case of presently residence to be the abject, it is a public offense crime which aqccompany fatality in human life. This is the well It now fact to all of us. And further in order to presentation to the crime of arson, strictness of criminal law (criminal law No, 164 and 169, and fire protection law No. 110 and 111) and classification of arsonist as felony are institutionary reinforced to punish with certainty of possibility, Therefore, as tendency of arson has been increased compared to other nations, it is necessary to supplement strategical policy to bring out overall concerns of the seriousness of risk and damage of arson, which have been resulted from the lack of understanding. In characteristics analysis of crime of arson, (1) It is now reveald that, in the past such crime rate appeared far more within the boundary of town or city areas in the past, presently increased rate of arsons in rural areas are far more than in the town or small city areas, thereby showing characteristics of crime of arson extending nation wide. (2) general timetable of arson shows that night more than day time rate, and reveald that is trait behavior in secrecy.(3) arsonists are usually arrested at site or by victim or report of third person(82,9%).Investigation activities or self surrenders rate only 11.2%. The time span of arrest is normally the same day of arson and at times it takes more than one year to arrest. This reveals its necessity to prepare for long period of time for arrest, (4) age rate of arson is in their thirties mostly as compared to homicide, robbery and adultery, and considerable numbers of arsons are in old age of over fifties. It reveals age rate is increased (5) Over half of the arsonists are below the junior high school (6) the rate of convicts by thier records is based on first offenders primarily and secondly more than 4 time convicts. This apparently shows necessity of effective correctional education policy for their social assimilation together with re-investigation of human education at the primary and secondary education system in thier life. The examples of motivation for arosnits, such as personal animosity, fury, monetary swindle, luscious purpose and other aims of destroying of proof, and other social resistance, violence including ways of threatening, beside the motives of individual defects, are diverse and arsonic suicide and specifically suicidal accompany together keenly manifested. When we take this fact with the criminal theory, it really reveals arsons of crime are increasing and its casualities are serious and a point as a way of suicide is the anomie theory of Durkheim and comensurate with the theory of that of Merton, Specifically in the arson of industrial complex, it is revealed that one with revolutionary motive or revolting motive would do the arsonic act. For the policy of prevention of arsons, professional research work in organizational cooperation for preventive activities is conducted in municipal or city wise functions in the name of Parson Taskforces and beside a variety of research institutes in federal government have been operating effectively to countermeasure in many fields of research. Franch and Sweden beside the U.S. set up a overall operation of fire prevention research funtions and have obtained very successful result. Japan also put their research likewise for countermeasure. In this research as a way of preventive fire policy, first, it is necessary to accomodate the legal preventitive activities for fire prevention in judicial side and as an administrative side, (1) precise statistic management of crime of arson (2) establishment of professional research functions or a corporate (3) improvement of system for cooperative structural team for investigation of fires and menpower organization of professional members. Secondly, social mentality in individual prospect, recognition of fires by arson and youth education of such effect, educational program for development and practical promotion. Thirdly, in view of environmental side, the ways of actual performance by programming with the establishment of cooperative advancement in local social function elements with administrative office, habitants, school facilities and newspapers measures (2) establishment of personal protection where weak menpowers are displayed in special fire prevention measures. These measures are presented for prevention of crime of arson. The control of crime and prevention shall be prepared as a means of self defence by the principle of self responsibility Specifically arsonists usually aims at the comparatively weak control of fire prevention is prevalent and it is therefore necessary to prepare individual facilities with their spontaneous management of fire prevention instead of public municipal funtures of local geverment. As Clifford L. Karchmer asserted instead of concerns about who would commit arson, what portion of area would be the target of the arson. It is effective to minister spontaveously the fire prevention measure in his facility with the consideration of characteristics of arson. On the other hand, it is necessary for the concerned personnel of local goverment and groups to distribute to the local society in timely manner for new information about the fire prevention, thus contribute to effective result of fire prevention result. In consideration of these factors, it is inevitable to never let coincide with the phemonemon of arsons in similar or mimic features as recognized that these could prevail just an epedemic as a strong imitational attitude. In processing of policy to encounter these problems, it is necessary to place priority of city policy to enhancement of overall concerns toward the definitive essense of crime of arson.

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간문부 담도암에서 수술 후 방사선 치료의 결과 (The Results of Postoperative Radiation Therapy for Perihilar Cholangiocarcinoma)

  • 이유선;박재원;박진홍;최은경;안승도;이상욱;송시열;이승규;황신;이영주;박광민;김기훈;안철수;문덕복;장흥문;류민희;김태원;이재련;김종훈
    • Radiation Oncology Journal
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    • 제27권4호
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    • pp.181-188
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    • 2009
  • 목 적: 수술 후 방사선치료를 시행한 간문부 담도암 환자를 대상으로 생존율, 재발양상, 예후 인자, 치료 부작용을 분석하여 방사선 치료의 결과를 알아보고자 하였다. 대상 및 방법: 98년 1월부터 2008년 3월까지 서울아산병원에서 근치적 또는 고식적 절제술 후 방사선 치료를 시행 받은 총 39명의 환자 중 총 방사선 조사량이 30 Gy 이상이었던 38명의 환자를 대상으로 후향적으로 분석하였다. 대상 환자들의 연령은 28~72세(중앙 연령, 59세)였으며, 남자가 23명 여자가 15명이었다. Eastern Cooperative Oncology Group (ECOG) 활동도는 모두 2 이하였다. AJCC에 따른 병리적 병기 1기, 2기는 각각 15명(40%), 23명 (60%)이었다. 수술은 완전 절제가 시행된 경우는 9명(24%), 절제연 양성인 경우는 29명(76%)이었다. 동시 항암화학요법은 30명(79%)에서 시행되었다. 방사선치료는 원발 종양이 있던 부위와 주변 림프절에 조사하였으며, 1회 선량은 1.8 Gy 또는 2 Gy로, 총 방사선량은 35~61 Gy (중앙값, 59.4 Gy)였다. 대상 환자들의 추적 관찰 기간은 6~45개월(중앙값, 14개월)이었다. 대상 환자의 생존율 분석은 Kaplan-Meier 법, 예후 인자 분석은 log-rank 법을 사용하였다. 결 과: 전체 환자의 3년 생존율은 30%, 3년 무진행 생존율은 8%이었으며, 중앙생존기간은 28개월이었다. 생존율에 유의하게 영향을 준 예후 인자는 종양의 분화도(p=0.003)였고, 무진행 생존율에 유의하게 영향을 준 예후 인자는 혈관-림프 침범(p=0.0307), 종양의 분화도(p=0.0245), 수술 후 CA 19-9 (p=0.0172)이었다. 완전 절제가 시행된 환자 9명의 3년 생존율은 34%로서 불완전 절제가 시행된 환자 29명의 20%보다 높았으나 유의한 차이는 보이지 않았다(p=0.3067). 최초 재발 양상은 국소 재발 18명(47%), 원격전이는 16명(42%)이었다. 치료에 연관된 EORTC Grade 3 이상의 급성 부작용은 관찰되지 않았으며, 만성 부작용으로는 십이지장 궤양에 의한 출혈이 2명(5.1%)에서 발생하였다. 결 론: 본 연구에서는 완전 절제가 시행된 경우와 절제연 양성인 경우에서의 생존율이 유의한 차이를 보이지 않아 방사선 치료의 국소재발 억제 효과가 있었을 가능성을 시사하였으나, 환자수가 적고 수술 단독군과의 비교가 이루어지지 않아 결론을 내리기는 어려웠다. 게다가 완전 절제 수술 후 방사선 치료를 시행한 군에서도 높은 국소 재발률을 보여, 향후 항암제와의 병용치료 및 정밀 방사선 치료 등을 통한 국소 제어율을 높이기 위한 연구가 필요하다.

정미기의 능률에 미치는 기계적 요인및 작동조건에 관한 연구 (Mechanical and Operational Factors Affecting the Efficiency of Rice Polishing Machines)

  • 노상하
    • Journal of Biosystems Engineering
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    • 제1권1호
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    • pp.15-15
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    • 1976
  • In analyzing the operational characteristics of a rice whitening machine, the internal radial pressure of the machine was measured using strain gage equipment. Changes in cylinder and feed screw configurations, screen type, cylinder speed and counter-pressure levels were examined to determine their impact on the quality and quantity of milled rice and the performance of the machine. The results are summarized as follows: 1. The internal radial pressure in the whitening chamber varied with the surface condition of the grain being processed. During the first or second pass through the machine, pressure was relatively low, reached a maximum after two to three passes with combinations I and II, three to six with combination III and then began to fall. 2. The pitch of the feed screw and the size of the feed gate opening which determine the rate of entry of grain into the whitening chamber, appeared to be the most important factor aff-::cting the degree of radial pressure, quality and quantity of milled rice and the efficiency of the machine. Using a feed screw with a wide pitch (4.8cm), radial pressure was relatively high and head rice recovery ratio \vere quite low. In this case capacity and machine effic?iency were much higher than obtained when using a feed screw with a narrow pitch (2.3cm). Very significant responses in radial pressure, head rice recovery rates and machine capacity were observed with changes in cylinder speed and counter-pressure levels when using the wide pitch feed screw. 3. The characteristics of the screen which surrounds the whitening chamber had an important effect on whitening efficiency. The existence of small protuberances on the original screen resulted in significant increases in both machine capacity and efficiency but without a significant decrease in head rice recovery or development of excessive radial pressure. Further work is required to determine the effects of screen surface conditions and the shape of the cylinderical steel roller on the rate of bran removal, machine efficiency and recovery rates. The size of the slotted perforations 0:1 the screen affects total milled rice recovery. The opening size on the original screen was fabricated to accommodate the round shape of Japonica rice varieties but was not suitable for the more slender Indica type. Milling Indica varieties with this screen resulted in a reduction in total milled rice recovery. 4. An increase in cylinder speed from 380 to 820 rpm produced a positive effect on head rice recovery for all machine combinations at every level of counter-pressure used in the tests. Head rice recovery was considerably lower at 380rpm using a wide screw pitch when compared to the results obtained at speeds from 600 to 820 r.p.m. The effects of cylinder speed On radial pressure, capacity and machine efficiency showed contrasting results, depending on the width of the feed screw pitch. With a narrow feed screw pitch (2.3cm), a direct proportional relationship was observed bet?ween cylinder speed and both radial pressure and machine efficiency. In contrast, using a 4.8 centimeter pitch feed roller produced a series of inverse relationships between the above variables. Based on the results of this study it is recommended when milling Indica type long grain rice varieties that the cylinder speed of the original machine be increased from 500-600 rmp up to a minimum of 800 rpm to obtain a greater abrasive effect between the grain and the screen. The pitch of the feed screw should be also reduced to decr?ease the level of internal radial pressure and to obtain higher machine efficiency and increased quality of milled rice with increased cylinder speeds. Further study on the interaction between cylinder speed and feed screw pitch is recommended. 5. An increase in the counter pressure level produced a negative effect On the head rice recovery with an increase in radial pressure, capacity, and machine efficiency over all combinations and at every level of cylinder speed. 6. Head rice recovery rates were conditioned primarily by the pressure inside the whitening chamber. According to the empirical cha racteristics curve developed in this study, the relationships of head rice recovery ($Y_h$) and machine capacity ($Y_c$/TEX>) to internal radial pressure ($X_p$) followed an inverse quadratic function and a linear function respectively: $$Y_h^\Delta=\frac{1}{{1.4383-0.2951X_p^\ast+0.1425X_p^{\ast\ast}}^2} , (R^2=0.98)$$$$Y_c^\Delta=-305.83+374.37X_p^{\ast\ast}, (R^2=0.88)$$The correlation between capacity and power consumption per unit of brown rice expressed in the following exponential function: $$Y_c^\Delta=1.63Y_c^{-0.7786^\{\ast\ast}, (R^2=0.94)$$These relationships indicate that when radial pressure increases above a certain range (1. 6 to 2.0 kg/$cm^2$ based On the results of the experiment) head ricerecovery decrea?ses in a quadratic relation with a inear increase in capacity but without any decrease in power consump tion per unit of brown rice. On the other hand, if radial pressure is below the range shown above, power consumption increases dramatically with a lin?ear decrease in capacity but without significant increases in head rice recovery. During the operation of a given whitening machine, the optimum radial pressure range or the correct capacity range should be selected by controlling the feed rate and/or counter-pressure keeping in mind the condition of the grain, particulary the hardness. It was observed that the total number of passes is related to radial pessure level, feed rate and counter-pressure level. The higher theradial pressure the fewer num?ber of pass required but with decreased head rice recovery. In particular, when using high feed rates, the total number of passes should be increased to more than three by reducing the counter-pressure level to avoid decreaseases in head rice recovery (less than 65 percent head rice recovery on the basis of brown rice) at every cylinder speed. 7. A rapid rise in grain temperature seemed to have a close relationship with the pressure generated inside the whitening chamber and, subsequently with head rice reco?very rates. The higher the rate of increase, the lower were the resulting head rice recoveries.

정미기의 능률에 미치는 기계적 요인및 작동조건에 관한 연구 (Mechanical and Operational Factors Affecting the Efficiency of Rice Polishing Machines)

  • 노상하;최재갑
    • Journal of Biosystems Engineering
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    • 제1권1호
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    • pp.17-48
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    • 1976
  • In analyzing the operational characteristics of a rice whitening machine, the internal radial pressure of the machine was measured using strain gage equipment. Changes in cylinder and feed screw configurations, screen type, cylinder speed and counter-pressure levels were examined to determine their impact on the quality and quantity of milled rice and the performance of the machine. The results are summarized as follows: 1. The internal radial pressure in the whitening chamber varied with the surface condition of the grain being processed. During the first or second pass through the machine, pressure was relatively low, reached a maximum after two to three passes with combinations I and II, three to six with combination III and then began to fall. 2. The pitch of the feed screw and the size of the feed gate opening which determine the rate of entry of grain into the whitening chamber, appeared to be the most important factor aff-::cting the degree of radial pressure, quality and quantity of milled rice and the efficiency of the machine. Using a feed screw with a wide pitch (4.8cm), radial pressure was relatively high and head rice recovery ratio \vere quite low. In this case capacity and machine effic\ulcorneriency were much higher than obtained when using a feed screw with a narrow pitch (2.3cm). Very significant responses in radial pressure, head rice recovery rates and machine capacity were observed with changes in cylinder speed and counter-pressure levels when using the wide pitch feed screw. 3. The characteristics of the screen which surrounds the whitening chamber had an important effect on whitening efficiency. The existence of small protuberances on the original screen resulted in significant increases in both machine capacity and efficiency but without a significant decrease in head rice recovery or development of excessive radial pressure. Further work is required to determine the effects of screen surface conditions and the shape of the cylinderical steel roller on the rate of bran removal, machine efficiency and recovery rates. The size of the slotted perforations 0:1 the screen affects total milled rice recovery. The opening size on the original screen was fabricated to accommodate the round shape of Japonica rice varieties but was not suitable for the more slender Indica type. Milling Indica varieties with this screen resulted in a reduction in total milled rice recovery. 4. An increase in cylinder speed from 380 to 820 rpm produced a positive effect on head rice recovery for all machine combinations at every level of counter-pressure used in the tests. Head rice recovery was considerably lower at 380rpm using a wide screw pitch when compared to the results obtained at speeds from 600 to 820 r.p.m. The effects of cylinder speed On radial pressure, capacity and machine efficiency showed contrasting results, depending on the width of the feed screw pitch. With a narrow feed screw pitch (2.3cm), a direct proportional relationship was observed bet\ulcornerween cylinder speed and both radial pressure and machine efficiency. In contrast, using a 4.8 centimeter pitch feed roller produced a series of inverse relationships between the above variables. Based on the results of this study it is recommended when milling Indica type long grain rice varieties that the cylinder speed of the original machine be increased from 500-600 rmp up to a minimum of 800 rpm to obtain a greater abrasive effect between the grain and the screen. The pitch of the feed screw should be also reduced to decr\ulcornerease the level of internal radial pressure and to obtain higher machine efficiency and increased quality of milled rice with increased cylinder speeds. Further study on the interaction between cylinder speed and feed screw pitch is recommended. 5. An increase in the counter pressure level produced a negative effect On the head rice recovery with an increase in radial pressure, capacity, and machine efficiency over all combinations and at every level of cylinder speed. 6. Head rice recovery rates were conditioned primarily by the pressure inside the whitening chamber. According to the empirical cha racteristics curve developed in this study, the relationships of head rice recovery ($Y_h$) and machine capacity ($Y_c$/TEX>) to internal radial pressure ($X_p$) followed an inverse quadratic function and a linear function respectively: $$Y_h^\Delta=\frac{1}{{1.4383-0.2951X_p^\ast+0.1425X_p^{\ast\ast}}^2} , (R^2=0.98)$$ $$Y_c^\Delta=-305.83+374.37X_p^{\ast\ast}, (R^2=0.88)$$ The correlation between capacity and power consumption per unit of brown rice expressed in the following exponential function: $$Y_c^\Delta=1.63Y_c^{-0.7786^\{\ast\ast}, (R^2=0.94)$$ These relationships indicate that when radial pressure increases above a certain range (1. 6 to 2.0 kg/$cm^2$ based On the results of the experiment) head ricerecovery decrea\ulcornerses in a quadratic relation with a inear increase in capacity but without any decrease in power consump tion per unit of brown rice. On the other hand, if radial pressure is below the range shown above, power consumption increases dramatically with a lin\ulcornerear decrease in capacity but without significant increases in head rice recovery. During the operation of a given whitening machine, the optimum radial pressure range or the correct capacity range should be selected by controlling the feed rate and/or counter-pressure keeping in mind the condition of the grain, particulary the hardness. It was observed that the total number of passes is related to radial pessure level, feed rate and counter-pressure level. The higher theradial pressure the fewer num\ulcornerber of pass required but with decreased head rice recovery. In particular, when using high feed rates, the total number of passes should be increased to more than three by reducing the counter-pressure level to avoid decreaseases in head rice recovery (less than 65 percent head rice recovery on the basis of brown rice) at every cylinder speed. 7. A rapid rise in grain temperature seemed to have a close relationship with the pressure generated inside the whitening chamber and, subsequently with head rice reco\ulcornervery rates. The higher the rate of increase, the lower were the resulting head rice recoveries.

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성문상부 상피세포암에서의 근치적 방사선치료의 역할 (The Role of Primary Radiotherapy for Squamous Cell Carcinoma of the Suprag1ottic Larynx)

  • 김원택;김동원;권병현;남지호;허원주
    • Radiation Oncology Journal
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    • 제18권4호
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    • pp.233-243
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    • 2000
  • 목적 :본 연구에서는 부산대학교병원 치료방사선과에서 성문상부 편평상피세포암으로 진단받고 근치적 방사선치료를 받은 환자들을 대상으로 방사선치료 성적과 여기에 영향을 미칠 수 있는 여러 인자들을 비교 분석하여 성문상부암에서의 방사선치료의 효율성과 역할, 그리고 앞으로의 치료방침의 결정에 있어서 고려해야 할 부분들을 알아보려 하였다. 대상 및 방법 : 1985년 8월부터 1996년 12월까지 성문상부암으로 진단되어 근치적 방사선치료를 받은 환자 32예를 후향적 분석을 통해 최소 29개월간 추적관찰 하였다. 6MV 광자선을 이용하여 조사영역 축소치료법과 통상적 분할조사 방법으로 원발부위와 주위 경부림프절을 평균 70.2 Gy로 치료하였고, 이중 13예는 cisplatin과 5-FU로 유도 항암화학요법을 시행받았다 병기별로는 1기가 5명(15.6$\%$), 2기가 10명(31.3$\%$), 3기가 8명(25$\%$), 4기가 9명(28.1$\%$)이었다. 결과 : 연구 결과 5년 전체 생존율과 국소제어율, 성문보존율은 각각 51.7$\%$, 65.2$\%$, 65.6$\%$였고, 병기별로의 생존율은, 1기, 2기, 3기, 4기 각각 80$\%$, 66.7$\%$, 42.9$\%$, 25.0$\%$였고, 국소제어율은 각각 100$\%$,60.0$\%$, 62.5%$\%$ 44.4$\%$였으며, 성문보존율은 각각 100$\%$, 70$\%$, 62.5$\%$, 44.4$\%$였다. 유도 화학요법을 실시한 군과 방사선 단독 군에서 생존율, 국소제어율 등에서 유의한 차이를 보이지 못했다. 치료실패를 보인 환자 중 7예에서 구제적 수술을 시행했고 이 중 3예에서 성공하였다. 치료 중 화학요법을 병용한 1예에서 중성구감소증으로 입원하였으며, 그 외에는 grade 3 이상의 급성 독성은 관찰되지 않았고, 치료 후 2예에서 심한 후두부종으로 기관절개술을 받았다. 원격전이는 4예에서 보였고(폐 3예, 뇌 1예), 2예에서 이차성 원발암이 발견되었다. T병기와 N병기, 총방사선량, 그리고 종양의 육안적 소견 등이 유의한 예 후인자였다. 결론 . 다른 연구들의 결과와 비교해 보았을 때, 조기 성문상부암인 경우 방사선치료와 보존적 수술이 생존율과 국소제어율에 비슷한 결과를 보이므로 후두기능 보존의 효과가 좋은 방사선치료 단독으로도그 역할을 충분히 할 수 있다 하겠으며, 진행된 병기의 경우에서는 방사선 단독 치료가 수술과의 병합 치료보다 예후가 월등히 좋지 않게 나타나므로 가급적 수술과 방사선치료 병합요법을 시도하는 것이 좋겠으나, 방사선치료를 해야만 하는 경우에서는 성문보존율과 국소제어율을 향상 시킬 수 있는 화학요법과의 병용치료, 특히 동시 화학방사선치료와 다분할 방사선치료, 그리고 방사선 민감제 등을 이용한보다 더 폭 넓은 연구와 치료계획의 수립이 필요하다고 하겠다.

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구인구직사이트의 구인정보 기반 지능형 직무분류체계의 구축 (Development of Intelligent Job Classification System based on Job Posting on Job Sites)

  • 이정승
    • 지능정보연구
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    • 제25권4호
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    • pp.123-139
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    • 2019
  • 주요 구인구직사이트의 직무분류체계가 사이트마다 상이하고 SW분야에서 제안한 'SQF(Sectoral Qualifications Framework)'의 직무분류체계와도 달라 SW산업에서 SW기업, SW구직자, 구인구직사이트가 모두 납득할 수 있는 새로운 직무분류체계가 필요하다. 본 연구의 목적은 주요 구인구직사이트의 구인정보와 'NCS(National Competaency Standars)'에 기반을 둔 SQF를 분석하여 시장 수요를 반영한 표준 직무분류체계를 구축하는 것이다. 이를 위해 주요 구인구직사이트의 직종 간 연관분석과 SQF와 직종 간 연관분석을 실시하여 직종 간 연관규칙을 도출하고자 한다. 이 연관규칙을 이용하여 주요 구인구직사이트의 직무분류체계를 맵핑하고 SQF와 직무 분류체계를 맵핑함으로써 데이터 기반의 지능형 직무분류체계를 제안하였다. 연구 결과 국내 주요 구인구직사이트인 '워크넷,' '잡코리아,' '사람인'에서 3만여 건의 구인정보를 open API를 이용하여 XML 형태로 수집하여 데이터베이스에 저장했다. 이 중 복수의 구인구직사이트에 동시 게시된 구인정보 900여 건을 필터링한 후 빈발 패턴 마이닝(frequent pattern mining)인 Apriori 알고리즘을 적용하여 800여 개의 연관규칙을 도출하였다. 800여 개의 연관규칙을 바탕으로 워크넷, 잡코리아, 사람인의 직무분류체계와 SQF의 직무분류체계를 맵핑하여 1~4차로 분류하되 분류의 단계가 유연한 표준 직무분류체계를 새롭게 구축했다. 본 연구는 일부 전문가의 직관이 아닌 직종 간 연관분석을 통해 데이터를 기반으로 직종 간 맵핑을 시도함으로써 시장 수요를 반영하는 새로운 직무분류체계를 제안했다는데 의의가 있다. 다만 본 연구는 데이터 수집 시점이 일시적이기 때문에 시간의 흐름에 따라 변화하는 시장의 수요를 충분히 반영하지 못하는 한계가 있다. 계절적 요인과 주요 공채 시기 등 시간에 따라 시장의 요구하는 변해갈 것이기에 더욱 정확한 매칭을 얻기 위해서는 지속적인 데이터 모니터링과 반복적인 실험이 필요하다. 본 연구 결과는 향후 SW산업 분야에서 SQF의 개선방향을 제시하는데 활용될 수 있고, SW산업 분야에서 성공을 경험삼아 타 산업으로 확장 이전될 수 있을 것으로 기대한다.